Online Employment Application Online Employment Application Step 1 of 4 25% Personal InformationName* First Last Address* Street Address Address Line 2 City Click to Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Are you 21 years or older?* Yes No Are you prevented from lawfully becoming employed in this country because of visa or immigration status?* Yes No Excluding minor traffic offenses, have you ever been convicted of a crime?* Yes No If yes, please explain:Desired EmploymentFor which position are you applying?* Date you are available to begin work?* MM slash DD slash YYYY Preferred salary?Are you currently employed?* Yes No If yes, may we inquire of your present employer? Yes No If you are currently employed, how much notice are you required to give prior to leaving? Have you ever applied with us before?* Yes No If yes, when and where? Did someone refer you?* Yes No If yes, who referred you? EducationDo you possess a high school diploma or equivalent?* Yes No Name and location of college(s) attended:*Area of studies?* Number of years attended?*Did you graduate?* Yes No Are you CDA or ACDS certified?* CDA ACDS Both No General InformationSubjects of special study or research work?Special skills?Have you served with any branch of the armed services?* Yes No If yes, with which branch did you serve and what was your rank? Are you presently a member of the National Guard or Reserves?* Yes No Employment HistoryCurrent/most recent place of employment?* What is/was your job title?* Start Date* MM slash DD slash YYYY End Date (if applicable) MM slash DD slash YYYY Supervisor or manager's name?* First Last Business Address* Street Address Address Line 2 City Click to Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone*Previous place of employment?* What was your job title?* Start Date* MM slash DD slash YYYY End Date* MM slash DD slash YYYY Supervisor or manager's name?* First Last Business Address* Street Address Address Line 2 City Click to Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone* Please give your honest opinion on each of the following questions:I feel I am qualified to work with children and families because...*List five characteristics you think are required of the position for which you are applying:*Why do you think you would work well at Playmates Preschools?*ReferencesReference #1 Name* First Last Reference #1 Phone*Relationship to Reference #1?* Reference #2 Name* First Last Reference #2 Phone*Relationship to Reference #2?* Reference #3 Name* First Last Reference #3 Phone*Relationship to Reference #3?* Application for Employment AgreementThe misrepresentation or withholding of information on this application provides sufficient reason for rejecting or immediately terminating a job applicant. Your digital signature below verifies that all information provided is true to the best of your knowledge. I also understand that, in signing below, I am authorizing Playmates Preschools & Child Development Centers, Inc. to complete a background investigation, including a criminal background check, and as a condition of employment with Playmates Preschools and Child Development Centers, Inc., I agree to abide by the following clauses. I further understand that failure to do so will result in immediate dismissal. CLAUSE ONE: I will read and become familiar with all sections of all day care regulations provided to me by my employer. I understand that strict adherence to these regulations are conditions of my continued employment. CLAUSE TWO: I will become familiar with and adhere to any and all federal, state, and local requirements relative to the reporting procedures for observed or suspected child abuse of any form. This also applies to any internal policies of Playmates Preschools and Child Development Centers, Inc. relating to this matter. CLAUSE THREE: I agree to maintain strict confidentiality concerning any and all events that take place at Playmates Preschools and Child Development Centers, Inc. I will not discuss matters relating to Playmates nor the clients thereof with any persons not designated by the parents or guardians to receive such information. Electronic Signature*If you agree to the above terms, please type your full name here. Today's Date* MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged. Application for Employment Step 1 of 4 25% Personal InformationName* First Last Address* Street Address Address Line 2 City Click to Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Are you 21 years or older?* Yes No Are you prevented from lawfully becoming employed in this country because of visa or immigration status?* Yes No Excluding minor traffic offenses, have you ever been convicted of a crime?* Yes No If yes, please explain:Desired EmploymentFor which position are you applying?* Date you are available to begin work?* MM slash DD slash YYYY Preferred salary?Are you currently employed?* Yes No If yes, may we inquire of your present employer? Yes No If you are currently employed, how much notice are you required to give prior to leaving? Have you ever applied with us before?* Yes No If yes, when and where? Did someone refer you?* Yes No If yes, who referred you? EducationDo you possess a high school diploma or equivalent?* Yes No Name and location of college(s) attended:*Area of studies?* Number of years attended?*Did you graduate?* Yes No Are you CDA or ACDS certified?* CDA ACDS Both No General InformationSubjects of special study or research work?Special skills?Have you served with any branch of the armed services?* Yes No If yes, with which branch did you serve and what was your rank? Are you presently a member of the National Guard or Reserves?* Yes No Employment HistoryCurrent/most recent place of employment?* What is/was your job title?* Start Date* MM slash DD slash YYYY End Date (if applicable) MM slash DD slash YYYY Supervisor or manager's name?* First Last Business Address* Street Address Address Line 2 City Click to Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone*Previous place of employment?* What was your job title?* Start Date* MM slash DD slash YYYY End Date* MM slash DD slash YYYY Supervisor or manager's name?* First Last Business Address* Street Address Address Line 2 City Click to Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone* Please give your honest opinion on each of the following questions:I feel I am qualified to work with children and families because...*List five characteristics you think are required of the position for which you are applying:*Why do you think you would work well at Playmates Preschools?*ReferencesReference #1 Name* First Last Reference #1 Phone*Relationship to Reference #1?* Reference #2 Name* First Last Reference #2 Phone*Relationship to Reference #2?* Reference #3 Name* First Last Reference #3 Phone*Relationship to Reference #3?* Application for Employment AgreementThe misrepresentation or withholding of information on this application provides sufficient reason for rejecting or immediately terminating a job applicant. Your digital signature below verifies that all information provided is true to the best of your knowledge. I also understand that, in signing below, I am authorizing Playmates Preschools & Child Development Centers, Inc. to complete a background investigation, including a criminal background check, and as a condition of employment with Playmates Preschools and Child Development Centers, Inc., I agree to abide by the following clauses. I further understand that failure to do so will result in immediate dismissal. CLAUSE ONE: I will read and become familiar with all sections of all day care regulations provided to me by my employer. I understand that strict adherence to these regulations are conditions of my continued employment. CLAUSE TWO: I will become familiar with and adhere to any and all federal, state, and local requirements relative to the reporting procedures for observed or suspected child abuse of any form. This also applies to any internal policies of Playmates Preschools and Child Development Centers, Inc. relating to this matter. CLAUSE THREE: I agree to maintain strict confidentiality concerning any and all events that take place at Playmates Preschools and Child Development Centers, Inc. I will not discuss matters relating to Playmates nor the clients thereof with any persons not designated by the parents or guardians to receive such information. Electronic Signature*If you agree to the above terms, please type your full name here. Today's Date* MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.