Stay and Play Employment Application

First Name

Last Name

Date

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Phone

EDUCATION & TRAINING

Name of High School

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Diploma

Date Received

Name of College

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Diploma

Date Received

Other:

Special Qualifications (technical or professional licenses, academic or professional awards, etc.

EMPLOYMENT HISTORY:
List Present or Most Recent Employer First

Employer's Name

From

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Phone

Type of Business

Name of Supervisor

Title of Supervisor

Your Job Title

Reason for Leaving

Briefly describe the nature of your position:

May we contact this employer?

Yes No

Next Employer Information:

Employer's Name

From

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Phone

Type of Business

Name of Supervisor

Title of Supervisor

Your Job Title

Reason for Leaving

Briefly describe the nature of your position:

May we contact this employer?

Yes No

Please describe your interest in this position, to summarize any additional information necessary to describe your full qualifications, and to explain answers to previous questions.

Draw your signature into the box below. The facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that, if employed, false statements on this application shall be sufficient cause for dismissal. I also understand that to qualify for employment, I will be subject to a criminal record check, Pennsylvania child abuse history clearance, and a medical examination.

Date

Stay and Play Preschool and Childcare does not descriminate on the basis of race, color, religion, national origin, sex, age, or disability as defined by law.
Stay and Play Preschool
132 W. Beaver Ave.
State College, PA 16801
email: stayandplayscpc@gmail.com

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Stay and Play Employment Application

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