APPLICATION FOR EMPLOYMENT
Outreach Children of God Fellowship Center
The Children's Learning Palace
Email : info@24hrdaycare.com
Print and Fax Option
PDF Version

Personal Information:











Shifts: 6am-2pm/2pm-10pm/10pm-6am

Education Level:
Did you Graduate?

Did you Graduate?

Did you Graduate?


Former or Current Employers





Job Title



May we Contact your supervisor? Name of Supervisor:

Description of Work:



Reason For Leaving:







Job Title



May we contact your supervisor? Name of Supervisor:

Description of Work:



Reason For Leaving:



Emergency Information:



Service Record: Discharge Date:

Have you ever been convicted of a felony within the last 5 years?

Have you ever been fired from a job within the past 5 years?

Do you have any physical disabilities that may exclude you from lifting 25lbs?

Please provide three references with the person's name, address, company name, and number of years known.



AUTHORIZATION
By typing my name below I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, unless it is in writing and signed by any authorized company representative.
Signature and Date: