The Learning Garden
A Quality Child Development and Preschool Center
Job Opportunities
APPLICATION FOR EMPLOYMENT
2100 Spencer Court • LaGrange, Kentucky 40031 • Phone (502)222-1700 • Fax (502) 222-8899
SECTION 1 – PERSONAL
Name _________________________________________________________________________________
Last First Middle
Social Security Number ___________________________________________________________________
Address _______________________________________________________________________________
Street City State Zip
Telephone Number ______________________________________________________________________
If under 18, list date of birth ___________________
County of Residence ___________________________
Note: You must be a US Citizen or otherwise authorized to work in the United States.
Proof of citizenship will be required as a condition of employment.
Have you been previously employed by us? ___ Yes ___ No
If yes, when? ___________________________
SECTION 2 – EMPLOYMENT DESIRED
Position(s) sought: ______________________________________________________________________
Hours Desired: _______________________ Starting Wage Desired: ____________
With reference to the position(s) you are seeking, are there any job-related functions that you are unwilling or unable to perform? ___ Yes ___ No
Note: If you need more information concerning job duties to answer this question, please inquire.
What date could you begin work? _________________________
Will you accept part time work? ___ Yes ___ No
SECTION 3 – EDUCATION AND TRAINING
Please circle the highest level of education completed: 8 9 10 11 12 Associate Bachelors Masters
Name of School City/State Graduate
___ Yes ___ No
______________________________________________________________________________________
High School
___ Yes ___ No
______________________________________________________________________________________
College
___ Yes ___ No
______________________________________________________________________________________
Other
SECTION 4 – PREVIOUS EMPLOYMENT
Please provide employment history below. If not continuously employed, please indicate reason.
Firm Rate Hours Nature of Work Supervisor
of Pay Per Week Name/Number
____________________________________________________________________________________________________________________________________________________________________________
Name
______________________________________________________________________________________
Address
______________________________________________________________________________________
Dates: From: To:
______________________________________________________________________________________
Reason for leaving:
__________________________________________________________________________________
Firm Rate Hours Nature of Work Supervisor
of Pay Per Week Name/Number
____________________________________________________________________________________________________________________________________________________________________________
Name
______________________________________________________________________________________
Address
______________________________________________________________________________________
Dates: From: To:
______________________________________________________________________________________
Reason for leaving:
__________________________________________________________________________________
Firm Rate Hours Nature of Work Supervisor
of Pay Per Week Name/Number
____________________________________________________________________________________________________________________________________________________________________________
Name
______________________________________________________________________________________
Address
______________________________________________________________________________________
Dates: From: To:
______________________________________________________________________________________
Reason for leaving:
__________________________________________________________________________________
May we contact your present employer? ___ Yes ___ No
If no, state reason _______________________________________________________________________
May we contact your previous employers? ___ Yes ___ No
If no, state reason _______________________________________________________________________
SECTION 5- PERSONAL REFERENCES (Not former employers or relatives)
______________________________________________________________________________________
Name Address Phone Occupation
______________________________________________________________________________________
Name Address Phone Occupation
______________________________________________________________________________________
Name Address Phone Occupation
SECTION 6 – GENERAL INFORMATION
Have you been convicted of a misdemeanor (other then minor traffic violations)? ___ Yes ___ No
Have you ever been convicted of a felony? ___Yes ___ No
If yes, explain fully, including offense, date, and location:
_______________________________________________________________________________________
_______________________________________________________________________________________
List other skills, qualifications or experience that you believe may be related to the job for which you are applying:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
List any other facts you feel might be important in considering your application for employment:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Tell us how you would handle discipline within the classroom.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
THE LEARNINGGARDEN IS AN EQUAL OPPORTUNITY EMPLOYER.
All qualified applicants will receive equal consideration (as required by applicable federal and state law), with out regard to race, age, color, religion, sex, national origin, or handicap.
APPLICANT’S STATEMENT AND AGREEMENT
I understand that no question on this application has been answered in such a manner as to disclose my race, color, religion, or national origin. If employed, I may be required to furnish proof of age. I understand that if I am hired, my employment will be at-will and may be terminated with or without cause and with or without notice at any time. I further understand that if I am hired, my job will include duties and tasks requested or directed by management, regardless of my job title. I understand that my previous employers may be asked for information concerning my employment, character, and experience. The Learning Garden will conduct background checks and I release persons making such inquiries from liability or damages incurred as a result of inquiring and furnishing this information. The facts set forth in my application for employment are true and complete. I understand that, if employed, false statements on this application shall be considered sufficient cause for dismissal. I understand that unless acted upon, this application will become inactive after 90 days.
Applicant Signature: _____________________________________________________________________
Date: _____________________________
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