Red Trolleys Daycare Valdosta, GA, 31601. , Best Daycare

If you are under age 18, can you submit a work permit if hired?

Yes

If you are not a US citizen, do you have a VISA to work in the US?

Yes

Has bond or security clearance ever been denied and/or canceled?

Yes

EDUCATION (Attach documentation of qualifying education)

	PLACE	DATES	DIPLOMA, CERTIFICATE,DEGREE
ELEMENTARY
SECONDARY
COLLEGE
OTHER(Experience with)

groups of children

Have you attended/completed any child care training courses?

Yes

PLEASE LIST EMPLOYMENT HISTORY FOR THE PAST TEN YEARS, BEGINNING WITH YOUR MOST CURRENT OR LAST EMPLOYER. If you have been unemployed during any time within the past ten years, list how you spent your time, e.g. student, housewife, unemployed, etc. If you need addition space please use separate employment record form

DAY/MONTH/YEAR	NAME AND ADDRESS OF EMPLOYER	POSITION
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO

Do you have a criminal record?

Yes

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

Yes

Under the American with Disabilities Act of 1991, this program is required to reasonably accommodate individuals with a disability. The reasonable accommodation requirement applies to the application process, any pre-employment testing, interviews and actual employment, but only if the program supervisor is made aware that an accommodation is required. If you are disabled and require accommodation, you may request it at any time during the interview process. You are obligated to inform the program director of your needs if it will impact your ability to perform the job for which you are applying.

Having read the job description for the position for which you are applying, are you in all respects

able to adequately perform the duties as described?

Yes

Do you have a valid driver’s license?

Yes

Have you had CPR training within the past two years?

Yes

Have you had first aid training within the past three years?

Yes

Bright from the Start: Georgia Department of Early Care Learning requires annual child care training, are you willing to participate?

Yes

10 YEAR EMPLOYMENT HISTORY

Record of Employment: Past 10 Years (If unemployed between 2 jobs/dates, write “no work”. Leave no gaps.

DAY/MONTH/YEAR	NAME AND ADDRESS OF EMPLOYER	POSITION	Reason for Leaving
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO
FROM TO

Application for Employment

Application for Employment

EDUCATION (Attach documentation of qualifying education)

groups of children

10 YEAR EMPLOYMENT HISTORY

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