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St. Francis Day Care Center
An apostolate of the Sisters of St. Francis of the Martyr St. George
"Let the children come to Me, for theirs is the Kingdom of Heaven." Luke 18:16
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Application for Employment
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St. Francis Day Care Center, in accordance with state and federal laws, does not discriminate on the basis of age, race, religion, sex, nation origin, marital status, physical or mental handicap, or disability.
Position Applied For:
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Date:
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Name Last / First / Middle:
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Phone:
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Address: Number / Street :
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City / State / Zip :
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Social Security Number:
Person to be notified in case of accident or emergency:
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Name / Address / Relationship:
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Emergency Contact Phone:
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Are you willing to work (check FT / or PT) :
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Full- time
Part-time
Date Available for work:
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Has St. Francis Day Care Center previously employed you?
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Yes
No
If yes, when?
Have you previously been legally prohibited from providing Child Care?
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Yes
No
If yes, explain :
Name of High School:
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High School Course of Study:
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Years Attended (From / To) :
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Last Year Completed:
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Did you Graduate?
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Yes
No
Name of College:
College Course of Study:
College Years Attended (From / To) :
College Years Completed:
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Did you Graduate from College?
Yes
No
Business / Name of School:
Business Course of Study:
Business Years Attended (From / To):
Business Last Year Completed:
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Did you Graduate from Business School?
Yes
No
Name of Other Schools:
Course of Study of Other Schools:
Years Attended Other Schools (From / To):
Last Year Completed Other Schools:
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Did you Graduate for Other Schools:
Yes
No
Have you had any experience working with children? Please describe:
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Please list and describe your interests and hobbies:
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Please list and describe the activities you have or may be involved in:
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Employment History: Beginning with the most recent employment, list all present and past employment (whether it was related to childcare or not) and indicate if you were employed under a different name. Attach additional sheet of information, if necessary.
List Company Name, Address, Phone #, and Person to Whom You Reported:
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List Position, Titles, And Type Of Work Performed:
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List Dates of Employment (From / To):
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Starting Hourly Wage :
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Ending Hourly Wage:
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Reason for Leaving:
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List Company Name, Address, Phone #, and Person to Whom You Reported:
List Position, Titles, And Type Of Work Performed:
List Dates of Employment (From / To):
Starting Hourly Wage :
Ending Hourly Wage:
Reason for Leaving:
List Company Name, Address, Phone #, and Person to Whom You Reported:
List Position, Titles, And Type Of Work Performed:
List Dates of Employment (From / To):
Starting Hourly Wage :
Ending Hourly Wage:
Reason for Leaving:
List Company Name, Address, Phone #, and Person to Whom You Reported:
List Position, Titles, And Type Of Work Performed:
List Dates of Employment (From / To):
Starting Hourly Wage :
Ending Hourly Wage:
Reason for Leaving:
Personal Reference:
Name:
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Address:
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Phone Number:
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Years Acquainted:
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Relationship:
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READ CAREFULLY:
I understand that nothing in this application or the granting of an interview creates a contract between St. Francis Day Care Center (hereinafter referred to as the Center) and myself for either employment of for the providing of any benefits. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the Center. If any employment relationship is established, I acknowledge that no consideration has been furnished to the Center for my employment other than my services, and I understand I have the right to terminate my employment at any time and that the Center has the same rights. The statements I have made in this application are correct to the best of my knowledge. If employed, I agree to conform to all rules and regulations of the Center. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. I understand and agree that the Center may make inquiry concerning my character, employment record, and other matters. I agree that the Center may give such information in the future. I hereby release the Center and all other persons from all liability in furnishing such information. I acknowledge that as part of the pre-employment screening process, any offer extended is contingent upon the successful submission of a fingerprint / background check, physical examination, and any other required documents applicable to employment in the United States. In event of my indebtedness to the Center, upon the termination of my service, I agree that salary due me is to be applied to my account.
Signature:
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Date:
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Any Additional Comments:
Email Address:
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