Kid's Place, Inc.
Employment Application
Kid's Place, Inc. is an Equal Opportunity Employer
Tell us about you            (Please fill in all boxes.
First Name
Last Name
Address
City
State Zip
Daytime phone number
E-mail Address
Position of Interest
Full Time Provider/Teacher

Part Time Provider/Teacher

Assistant Full Time Provider/Teacher

Assistant Part Time Provider/Teacher

Subsititute
Education
High School
Graduated (year)
College
Major
Years Attended
Degree Recieved
College
Major
Years Attended
Degree Recieved
Employment Experience
Company
Job Title
Address
City
State Zip
Supervisor
to
Employed From                              
Wage
Reason for leaving
Responsibilities
Company
Job Title
Address
City
State Zip
Supervisor
to
Employed From                              
Wage
Reason for leaving
Responsibilities
Company
Job Title
Address
City
State Zip
Supervisor
to
Employed From                              
Wage
Reason for leaving
Responsibilities
References
Personal References (Non-Relavtive)
Name
Address
City State
Zip
Phone
Years known
Name
Address
City State
Zip
Phone
Years known
Name
Address
City State
Zip
Phone
Years known
Additional Qualifications
CPR/First Aid
If yes-Date Expires
If no leave blank
Please tell us about any other training, education, skills or achievements that you feel should be considered.
Explain your past work experience with children.
What age group are you most comfortable working with and why?
How comfortable are you working with parents?
What would you like to gain from this position?
Additional Information
Please submit and the director will be in contact with you in a timely manner.

And thank you again for inquiring about becoming a member of the Kid's Place, Inc. team!
Hosted by www.Geocities.ws

1