Creative Kids Academy Employment Application

Creative Kids Academy

Application for Employment

An Equal Employment Opportunity/Affirmative Action Employer

Date:______

Name______

First Middle Last

Current Address______

Street City Zip

Phone Number ______

Home Cell

Email______

Driver’s License Number______

Are you legally eligible to work in the US?______CKA requires documentation upon hire.

Referred by ______

Employment Desired

Position ______Date Available ______

Salary Desired ______

What prompted your application with us? ______

Education

Schools Attended Dates attended Major

______

Would you be willing to continue your education by enrolling in courses or other training programs that may be recommended? ______

Please list any courses, volunteer work, or training that would relate to the position you are applying for: ______

Employment History

Former Employers

Name ______Dates: from ______to ______

Address______Salary on leaving ______

Phone ______Duties ______

Position______Supervisor’s Name ______

Reason for leaving ______

Name______Dates: from______to______

Address______Salary on leaving ______

Phone ______Duties ______

Position ______Supervisor’s Name ______

Reason for leaving ______

Name ______Dates: from ______to _____

Address ______Salary of leaving ______

Phone ______Duties ______

Position ______Supervisor’s Name ______

Reason for leaving ______

References

Please list at least three persons, not related to you, you have known at least one year who could attest to your interaction with children.

______

Name Phone Number Relationship

______

Name Phone Number Relationship

______

Name Phone Number Relationship

General Information

Are you able to perform the essential functions of this job with or without reasonable accomadations?______

Are you available between 6:00am and 6:00pm?______

Would you object to being fingerprinted? ______

Have you been convicted of a crime? ______

Are you able to lift a minimum of 35 pounds?______

Do you have reliable transportation? ______

Are you available for part time work? ______

Are you available for substitute work? ______

General Information

In compliance with Minnesota statutes and requirements, no person shall be hired or retained as a staff member, paid or volunteer who has:

1) been convicted of or admitted to or been the subject of substantial evidence of an act of child battering, child abuse, or child molesting

2) used alcohol or drugs such that its effects are apparent during working hours that children are in care, or,

3) been convicted for or admitted to any felony or any offense involving moral turpitude.

I am aware that a background study will be performed before I can be hired. I give permission for Creative Kids to use the information I have filled out on this application for the background study. I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts is cause for dismissal. I understand that I am responsible for all background study fees. I also understand that I will be responsible for getting fingerprinted and my photo taken in the time frame given to me or my offer of employment may be recinded.

In the event of my employment with Creative Kids I agree to comply with all of the rules and policies governing my employment. In the event I should terminate my employment, I agree to file my resignation two weeks prior to the date it will be effective. I understand that three months of my employment are probationary and if my services have not proved satisfactory, my employment may be discontinued at any time.

Applicant’s Signature ______

Date:______

Confidential Information - Creative Kids Academy Employment Application