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0190500833-874-7387 Ext. 28754 RR 2243, Leander, TX 78641 PLEASE SUBMIT COMPLETED FORM TO: Lauren@Upwards.ChurchEMPLOYMENT APPLICATIONNAME: ___________________________________________DATE: ____________________________SOCIAL SECURITY #: _________________________________DATE OF BIRTH: ____________________ADDRESS: _________________________________________EMAIL: _______________________________________CITY, STATE, ZIP: ____________________________________________________________________________________HOME PHONE: ____________________________________CELL PHONE: __________________________________POSITION DESIRED: ________________________________DATE AVAILABLE TO START: ______________________Please list your prior work experience in Early Childhood Education or field related to position sought starting with your most recent place of employment. Please include up to three.EMPLOYER NAME:ADDRESS:PHONE NUMBER:POSITION HELD:LENGTH OF EMPLOYMENT:REASON FOR LEAVING:MAY WE CONTACT THIS EMPLOYER: Yes / NoGENERAL JOB RESPONSIBILITIES:GENERAL JOB RESPONSIBILITIES:EMPLOYER NAME:ADDRESS:PHONE NUMBER:POSITION HELD:LENGTH OF EMPLOYMENT:REASON FOR LEAVING:MAY WE CONTACT THIS EMPLOYER: Yes / NoEMPLOYER NAME:ADDRESS:PHONE NUMBER:POSITION HELD:LENGTH OF EMPLOYMENT:REASON FOR LEAVING:MAY WE CONTACT THIS EMPLOYER: Yes / NoGENERAL JOB RESPONSIBILITIES:EDUCATIONNAME & ADDRESS OF SCHOOLCOURSE OF STUDY# OF YEARSATTENDEDDEGREE /DIPLOMAHIGH SCHOOLPROFESSIONAL CERTIFICATEUNDERGRADUATE COLLEGE/UNIVERSITYGRADUATE / PROFESSIONAL DEGREEOTHERYou must attach to this application a copy of the Diploma/Certificate from your highest level of education achieved. Please also attach official copies of your undergraduate and/or graduate transcripts if applicable.Please list any additional Educational/Specialized Training you have received related to the job for which you are applying: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PERSONAL / PROFESSIONAL REFERENCES: Do not include family or past supervisors:NAMEPHONE #RELATIONSHIP TO YOUPROFESSIONPlease answer the following questions with yes or no:Are you at least 18 years of age? __________ Can you provide proof of your age if required? ___________Are you a U.S. citizen or have appropriate documentation to show you are eligible to work in the U.S.? _________(Proof of citizenship or immigration status will be required upon employment.)3.Are you available to work any time as scheduled between the hours of 8:30 AM – 2:30 PM? __________If no, please indicate the times you are available to work: _______________________________________________4.To your knowledge are you related to any child currently enrolled in this program? __________If yes, please list child’s name and your relationship: __________________________________________________________________________________________________________________________________________________5.To your knowledge are you related to anyone currently serving on the Board of Directors for Upwards Preschool?__________ If yes, please list the Board Member’s name and your relationship: ______________________________________6.Have you ever been convicted of or have an indicated report of any crime against a child? __________7.Have you ever been convicted of any crime or have pending criminal actions against you? __________If yes, please explain: ____________________________________________________________________________________________________________________________________________________________________________Do you have preschool age children who need to attend Upwards Preschool? _________ If yes, what age(s) __________What church are you presently attending? ______________________________ Are you a member? ________________Do you attend regularly? __________ Are you actively involved in your church? __________ If so, how?________________________________________________________________________________________________________________PERSONAL QUESTIONNAIRE (Please continue on the back side if you need more room to complete the questions.):1.Give a brief biographical sketch of your life? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2.Why have you chosen to work in Early Childhood Education? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________3.What is your personal testimony on how you came to know Christ? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________4.What do you believe are your best qualifications to work with the children and parents at Upwards Preschool? __________________________________________________________________________________________________________________________________________________________________________________________________5.How would you respond to a child in your class that is being extremely disruptive? _________________________________________________________________________________________________________________________________________________________________________________________________________________________6.Describe what you consider to be the most important part of a day working with children? _________________________________________________________________________________________________________________________________________________________________________________________________________________7.What impact do you see yourself making at Upwards Preschool? _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________APPLICANT’S STATEMENT:I certify that the answers and information given herein are true, correct and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in termination regardless of when the information is discovered to be false or misleading.PRINTED NAME: ______________________________________________________DATE: ____________________SIGNATURE: _________________________________________________________Thank you for your interest in being employed with Upwards Preschool. Upon review of completed applications, a representative of Upwards Preschool will schedule interviews with applicants who meet the initial requirements as evidenced by the information provided herein.-5715967105FOR OFFICE USE ONLY:Received by: ____________________________________ Date: ______________________Interviewed Scheduled: Date: ______________________ Time: _______________ Location: _______________________00FOR OFFICE USE ONLY:Received by: ____________________________________ Date: ______________________Interviewed Scheduled: Date: ______________________ Time: _______________ Location: _______________________Upwards Preschool is an “AT-WILL” employer. The “AT-WILL” employment relationship affords the employee the right to resign for any reason. Likewise, the employer may terminate the relationship at any time, with or without cause and with or without notice. The “AT-WILL” employment relationship may not be altered by any written document or by verbal agreement, unless such alteration is specifically acknowledged in writing and signed by an authorized executive of Upwards Preschool. ................
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