Scribbles and Giggles Child Care Learning Center

APPLICATION FOR EMPLOYMENT

Scribbles & Giggles Child Care Learning Center

609 N. Verlinden Ave Lansing, MI 48915

Phone 517-482-1551

AN EQUAL OPPORTUNITY EMPLOYER

www.scribblesandgiggleschildcare.com

E-Mail~brynn.kelley@scribblesandgiggleschildcare.com

PLEASE PRINT

I. POSITION INFORMATION

Position applied for_____________________ Date of application___________

Hours available to work { }morning { }afternoon M T W T F (circle all that apply)

Type of employment desired: Full-time, Part-time, Temporary Date available _____________________

II. GENERAL INFORMATION

Name______________________________________________________

First Middle Last

Address______________________________________________________________________

Street Apt #

_____________________________________________________________________

City State Zip

Social Security Number ___________________________________

Date of birth_____________________________

Cell phone ____________________________________

Home Phone _____________________Work Phone ______________________

Home Email _____________________ Work Email _______________________

Where do you prefer to be contacted (check all preferred) cell home work home email work email

Have you filed an application with us in the past? yes no If yes, give dates _______________________________________________________________

Have you been employed by us in the past? yes no If yes, give dates _________________________________________________________

Are you legally eligible for employment in this country? yes no

(Proof of U.S. Citizenship or Immigration status will be required upon employment.)

A criminal records background check is required prior to final approval of any offer.

Have you been convicted of a felony in the last 7 years? yes no

If yes, please explain ______________________________________________________________

Do you possess a valid Michigan Driver’s license? yes no

Do you have a vehicle available for your use on a daily basis? yes no

III. EDUCATIONAL BACKGROUND

List all college and university experiences. Include High School if relevant.

_______________________________________________________________

Name and location of Institution Years attended Degree/ year Major/ Minor # Credits

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

IV. EMPLOYMENT HISTORY

List your prior employers, assignments or volunteer activities starting with the most recent, including military experience. Explain any gaps in comment section below.

Employer Dates employed___________________________________________

From To_________________________________________________________

Address_________________________________________________________

Phone__________________________________

Job title________________________________________

Salary/ hourly rate________________________________

Immediate supervisor and title May we contact for reference

yes no later

Reason for leaving_________________________________________________

________________________________________________________________

Summarize job responsibilities_______________________________________

_______________________________________________________________

Employer Dates employed___________________________________________

From To_________________________________________________________

Address_________________________________________________________

Phone___________________________________________________________

Job title_______________________________________

Salary/ hourly rate_______________________________

Immediate supervisor and title May we contact for reference

yes no later

Reason for leaving_________________________________________________

Summarize job responsibilities_______________________________________

Employer Dates employed___________________________________________

From To_________________________________________________________

Address_________________________________________________________

Phone_______________________________

Job title_______________________________________________

Salary/ hourly rate_______________________________________

Immediate supervisor and title May we contact for reference

yes no later

Reason for leaving________________________________________

Summarize job responsibilities_______________________________________

_______________________________________________________________

EMPLOYMENT HISTORY CONTINUED

Employer Dates employed_____________________________________

From To_________________________________________________________

Address_________________________________________________________

Phone__________________________________________________________

Job title_________________________________________________________

Salary/ hourly rate_________________________________________________

Immediate supervisor and title

May we contact for reference

yes no later

Reason for leaving_________________________________________________

Summarize job responsibilities_______________________________________

_______________________________________________________________

Comments_______________________________________________________

_______________________________________________________________

V. REFERENCES

List name and telephone number (including area code) of 3 business/work references that are not related to you and are not listed as your supervisor in part I.

Name Phone number Relationship/ years known

1_______________________________________________________________

2_______________________________________________________________

3______________________________________________________________

VI. SKILLS AND QUALIFICATIONS

Summarize your knowledge and experience with children.

_______________________________________________________________

Summarize any other skills, special training, licenses and/or characteristics related to the position you are applying for:

_______________________________________________________________

List special accomplishments, publications, awards and such.

_______________________________________________________________

APPLICANT'S CONSENT

Please read the following statement carefully before signing.

I have voluntarily completed this application because I am interested in employment with Scribbles and Giggles Child Care Learning Center. I am at least 18 years of age. I declare and affirm that the information I have provided is to the best of my knowledge correct and complete. I agree that any misstatement(s) or omission(s) as to material facts will constitute grounds for unfavorable consideration or dismissal from employment.

I understand that this application in no way obligates Scribbles and Giggles Child Care Learning Center to hire me. I understand that if employment is offered and accepted, I will be required to successfully complete an initial probationary period. I agree and understand that if employed, my criminal record will be checked through the Michigan Department of Public Safety and will be fingerprinted. I agree and understand that such employment is for an indefinite period and is solely on an "at-will" basis. I agree and understand that my employment may be terminated, by either Scribbles and Giggles Child Care Learning Center or myself at any time, with or without cause, and with or without notice.

I authorize my background information contained in this application be released to Scribbles and Giggles Child Care Learning Center and/or any other person, organization or institution from any and all liability that may result from any investigation into my background conducted by Scribbles and Giggles Child Care Learning Center and it's management staff.

_________________________________ ______________________

Applicant Signature Date