KIDS’ DAY
OUT PROGRAM
Position Appling For
____________________________
Application
for Employment
Applicant
Name ______________________________________________________________
Address
________________________________________
Zip Code ___________________
Phone ________________________________ SS
#_____/___/_________
Alternate
(cell) phone: _______________________
Driver’s
License # _________________________
Please give a short testimony of your
faith in Jesus:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
PREVIOUS EMPLOYMENT: (begin with latest
first):
Employer:
________________________________ Address _____________________________
Dates
employed ____________ to ______________ Supervisor __________________________
Responsibilities
________________________________________________________________
Employer:
________________________________ Address _____________________________
Dates employed ____________
to ______________ Supervisor __________________________
Responsibilities
________________________________________________________________
Employer:
________________________________ Address _____________________________
Dates employed ____________
to ______________ Supervisor __________________________
Responsibilities
________________________________________________________________
EDUCATION: (begin with High School):
School:
_____________________________ Location ________________________________
Degree completed
____________________
School:
_____________________________ Location ________________________________
Degree completed
____________________
PERSONAL REFERENCES:
Name
_____________________________________ Phone _____________________________
Relationship ________________________
Name
_____________________________________ Phone _____________________________
Relationship
________________________
HOBBIES/SPECIAL INTERESTS:
(please list any special interests or hobbies)
____________________________________________________________________________________________________________________________________________________________
I certify that the information provided is true and accurate. I give authorization to contact
Signature___________________________________________Date______________
* * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *
* * * * (OFFICE USE ONLY)
Cent. Reg check_____ D.L. copy ______ Ref check. ______ HI _______ Teach. Cert._______
Date of
Hire ____________ Date
of Sep.__________