Hand In Hand Daycare and Preschool, Inc.
Application for Employment

Personal Information      
Date S.S. #
Name Phone #
Address Apt. #
City Zip
Emergency Contact Contact #
Position applied for? Date you can start
Full Time/Part Time    
Salary desired Are you at least 18 years of age
Education/Experience      
Did you graduate High School? If not, do you have a GED?
Do you have any higher education? If so, where and what field of study?
Do you have experience in childcare? How many years?
Do you have any special training that might apply? If so, explain
Employment References
List your three most recent employers.
From To Name Address City Phone Position Held Rate of Pay Reason for Leaving
May we contact your previous employers? If not, why?
Do you have any hobbies, special interests, or talents?    

How would you rate yourself 1-10 in the following areas: (10 being great)
Organization Punctuality Cleanliness Handle Criticism Creativity Teamwork
From your past experiences, what are some of your likes and dislikes in working in a childcare setting?
Describe a disciplinary incident involving children, and explain how you handled the situation, or would handle it.
What method of discipline do you feel is most effective, and why?
Personal References      
Name Relation Phone # Years Known
Do you have any limitations to keep you from performing childcare duties, such as diaper changing or other lifting? 
If so, explain
Do you need childcare? If so, what ages?
Do you have First Aid or CPR certification?    

I understand that to be considered for a position in this center I need to obtain a negative TB skin test and a criminal records check..(Form to be supplied by the center) I am also required to obtain 12 hours of training annually to maintain my employment.

I, (Type Name)   understand all questions and statements above, and declare that all answers and statements are true. False or misleading information is grounds for rejection of application or termination of employment.
Hours of availability