Day School Job Application Form Fill out the form below! Personal InformationName* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Please give your last 5 years of employment to include any time as a fulltime student or unemployed*Name/City/StatePhoneFrom / ToPosition Held Example: ABC Day Care / Beaumont / TX -- 325-642-1234 -- Jan. 2016 to present -- childcare worker Sherman High School / Sherman / TX -- 903-642-1234 -- Aug. 2012 / May 2016 -- Full time student Click the (+) for additional linesUpload Resume*Accepted file types: doc, docx, pdf, txt, rtf, Max. file size: 50 MB.Date of Employment* MM slash DD slash YYYY Date FBI Fingerprint Check Completed* MM slash DD slash YYYY TB Test Date* MM slash DD slash YYYY Name of High School/Home School* Did you graduate?* Yes No Graduation Date* MM slash DD slash YYYY GED Date* MM slash DD slash YYYY CPR Training Expiration Date MM slash DD slash YYYY First Aid Training Expiration Date* MM slash DD slash YYYY CPR Certification Upload*Accepted file types: doc, docx, pdf, txt, rtf, Max. file size: 50 MB.Pre-Service Training (For Caregivers)Select which applies to you* I have previous child care experience or training (DOES NOT REQUIRE 24 HRS of PRE-SERVICE) OR I do not have previous child care experience or training. Before being counted in the child/caregiver ration, I received 8 hours of pre-service training in the following areas:* Developmental stages of children Positive guidance and discipline of children Supervision and safety practices in the care of children Preventing the spread of communicable disease Age-appropriate activities for children Fostering children's self-esteem Positive interaction with children Select all that applySelect which applies to you* I will not be working with children younger than 24 months. (DOES NOT REQUIRE THE TRAINING LISTED BELOW) OR I will be working with children younger than 24 months. Before being counted in the child/caregiver ratio for a group of children younger than 24 months of age, I received one hour of pre-service training in the areas listed below* Recognizing and preventing shaken baby syndrome and abusive head trauma; Understanding and using safe sleep practices and preventing sudden infant death syndrome (SIDS); and Understanding early childhood brain development. Attached DocumentsCopy of photo identification*Accepted file types: jpg, png, pdf, Max. file size: 50 MB.Copy of current driver's license for persons transporting children in careAccepted file types: jpg, png, pdf, Max. file size: 50 MB.Not applicable if not transporting childrenStaff Training Record (Form 7258)*Accepted file types: jpg, png, pdf, doc, docx, rtf, txt, Max. file size: 50 MB.Educational DocumentationAccepted file types: jpg, png, pdf, doc, docx, rtf, txt, Max. file size: 50 MB.SignatureApplicant Signature* First Last By typing your name, you acknowledge that you are the person represented in this form and everything you have stated in this form is true and accurate. Δ
