Careers - Small World Learning Center

CITIZENSHIP

Check if you are a US Citizen. Check if you are NOT a US Citizen. Check if you have completed an I-9 document.

Answer the following if you are not a US citizen:

Check if you have a VISA to work in the US.

If yes, what kind of VISA classification?

VISA registration number:

VISA expiration date:

Check if bond or security clearance has ever been denied and/or canceled.

If yes, please explain:

POSITION INFORMATION AND AVAILABILITY

Position Applying for

Position Type

Part Time Full Time

If PT Days Available

Diploma Certificate or Degree

Check if you DO NOT HAVE experience with children. Check if you have experience with children. Check if you have experience with children with disabilities.

List Most Recent Job First

Employer Phone Number:

May We Contact?

Yes No

Do you have any children that need childcare while you are at work?

Yes No

If Yes, Age(s) of Child/Children:

If Yes, Name(s) of Child/Children:

*Please note while we do offer childcare benefits for our staff, enrollment is not guaranteed.

Do we have your consent to do a background check with the state?

Yes No

If not, please be aware that we will not hire as this is a requirement from the state.

Do you have a criminal background?

Yes No

Have you ever been shown by creditable evidence, e.g., a court order or jury, a department investigation, or other reliable evidence, to have abused, neglected, or deprived a child or adult or to have subjected any person to serious injury because of intentional or grossly negligent misconduct?

Yes No

Do you have a valid driver’s license?

Yes No

If yes, provide the license number:

Can you perform the essential function of the position you are applying for?

Yes No

Have you completed CPR and First-Aid training?

Yes No

Date of expiration for CPR and First-Aid Training:

Our state licensing department requires annual childcare training. Are you willing to participate?

Yes No

ACKNOWLEDGEMENT OF EMPLOYMENT APPLICATION

I hereby certify that all the information provided in this employment application is true and complete. I understand that false information or the omission of information may disqualify my candidacy and may be grounds for termination. I further understand that I am applying to a Drug-Free Workplace and may be required to submit to testing for the presence of drugs as a condition for employment.

Employment Application