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Application for Employment
This application is to be completed by those desiring a teaching or aide position involving the supervision or custody of minors. It is used to help MMF Preschool provide a safe and secure environment for children in our care.
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* Indicates required question
Legal Name (First, Middle, Last):
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Your answer
Address (Street, City, State, Zip)
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Your answer
How long have you been at this address:
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Your answer
If less than five years, please give previous address and number of years:
Your answer
Birthday:
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MM
/
DD
/
YYYY
Primary Phone Number:
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Your answer
Social Security Number:
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Your answer
Driver's License State, Number, and Expiration Date:
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Your answer
Email address:
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Your answer
Emergency Contact Name, Phone number, Relation:
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Your answer
Position Applied For:
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Teacher
Classroom Aide
Age Preference:
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Toddlers
2-3 year olds
3-4 year olds
4-5 year olds
Required
Personal Information
Marital Status:
Single
Married
Clear selection
Spouse's Name:
Your answer
Number of Children:
Your answer
Names and Ages:
Your answer
Do you have any preschool age children you would be enrolling?
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Yes
No
If yes, please provide Name, birthdate, potty trained or diapers, and if the child naps:
Your answer
Education
High School, including City/State:
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Your answer
Dates Attended:
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Your answer
Did you graduate?
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Yes
No
College/Other, including City/State:
Your answer
Dates Attended:
Your answer
Did you graduate?
Yes
No
Clear selection
Degree:
Your answer
Employment History:
Are you a citizen of the United States?
*
Yes
No
Can you provide legal authorization to work?
*
Yes
No
Have you ever been convicted of a felony?
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Yes
No
If yes, please explain:
Your answer
What leadership or volunteer experience do you have with children?
*
Your answer
Please list any Early Childhood training or education that you have received.
Your answer
Are you CPR/First Aid Certified?
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Yes
No
If yes, when does your certificate expire?
MM
/
DD
/
YYYY
Most Recent Employers:
Date range of employment
Your answer
Company
Your answer
Phone Number:
Your answer
Address (Street, City, State, Zip)
Your answer
Supervisor:
Your answer
Job Title
Your answer
Salary
Your answer
May we contact this employer?
Yes
No
Clear selection
Responsibilities
Your answer
Reason for leaving:
Your answer
Date range of employment
Your answer
Company
Your answer
Phone Number:
Your answer
Address (Street, City, State, Zip)
Your answer
Supervisor:
Your answer
Job Title
Your answer
Salary
Your answer
May we contact this employer?
Yes
No
Clear selection
Responsibilities
Your answer
Reason for leaving:
Your answer
Date range of employment
Your answer
Company
Your answer
Phone Number:
Your answer
Address (Street, City, State, Zip)
Your answer
Supervisor:
Your answer
Job Title
Your answer
Salary
Your answer
May we contact this employer?
Yes
No
Clear selection
Responsibilities
Your answer
Reason for leaving:
Your answer
References
Please list two personal references (must be at least 18 years old and a non-relative)
Name and Phone Number
*
Your answer
Name and Phone Number
*
Your answer
Name and Phone Number
Your answer
What are two reasons you are interested in teaching and working with preschoolers?
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Your answer
List at least two of your strengths in the area of teaching.
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Your answer
Applicant's Statement
I hereby authorize MMF Preschool to verify all information contained in this application with any references, past or present employers, or any other appropriate personnel at past or present employers, churches or other organizations and any individuals to disclose any and all information to MMF Preschool's collection of all such evaluations or information or its consideration of my application.
Please sign your name and date below:
Your answer
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