The Learning Garden Preschool - 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
High School		Yes No
College		Yes No
Other		Yes No

SECTION 4- PREVIOUS EMPLOYMENT

Please provide employment history below. If not continuously employed, please indicate reason.

Firms	Rate Of Pay	Hrs Per Week	Nature of Work	Supervisor Name/Number
Name
Address
Dates: From: To:
Reason for leaving:
Name
Address
Dates: From: To:
Reason for leaving:
Name
Address
Dates: From: To:
Reason for leaving:
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

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: _________________________________________