Purchase Children's Center | Employment Application

First Name: Last Name:

Street Address: City: State: Zip:

Home Phone: Cellphone: Birthdate:

Present Occupation: Gender

Email Address:

Educational Background

Education	Name of School	Current Year or Last Year Completed	Did You Graduate?	Year Graduated	Degree and/or Major
High School
College
Post College
Trade School

Work Experience (List PAID EXPERIENCE in order of most recent position.)

Type of Work	Organization	Dates	Employer	Phone

Volunteer Experience (List any VOLUNTEER EXPERIENCE you have had.)

1.
2.
3.

Experience with Children (What related experience with children have you had? Teaching, babysitting, etc. (include dates, locations, ages & gender)

Certifications - Please indicate any CURRENT certifications you have below.

CDA Certification	CPR
Standard First Aid	Other (specify)

Character and References - List 3 people who know of your work such as teachers, employers, etc. No family members, please.

	Name	Address	Phone Number
1.
2.
3.

Have you ever been charged, either criminally or civally, with sexual abuse, sexual harassment or discrimination?

Have you ever been convicted of a felony?

If you answered YES to either of the last two questions, please explain.

Activities - Select "LIKE" next to the activites that you like to do. Select "TEACH" next to activities that you could teach or help teach.

Arts & Crafts	Science	Music	Nature
Cooking	Sports	Singing	Dance
Gymnastics	Photography	Improv/Theatre	Carpentry
Other:

Are you available to work weekday mornings?

How did you hear of the Purchase Children's Center? If through a friend, who?

The following question is to prevent spam and must be answered correctly to submit the application. The color of a ripe pumpkin is...?

First Name:

Last Name:

Street Address:

City:

State: Zip:

Home Phone:

Cellphone:

Birthdate:

Present Occupation:

Gender:

Email Address:

Educational Background

High School
Name of High School:

Current Year or Last Year Completed:

Did you Graduate?

Year Graduated:

Degree and/or Major:

College
Name of College:

Current or Last Year Completed:

Did you Graduate?

Year Graduated:

Degree and/or Major:

Post College
Name of Post College:

Current or Last Year Completed:

Did you Graduate?

Year Graduated:

Degree and/or Major:

Trade School
Name of Trade School:

Current or Last Year Completed:

Did you Graduate?

Year Graduated:

Degree and/or Major:

Work Experience

(List PAID EXPERIENCE in order of most recent position.)

Work Experience (most recent)
Type of Work:

Organization:

Dates:

Employer:

Employer Phone:

Work Experience (previous)
Type of Work:

Organization:

Dates:

Employer:

Employer Phone:

Volunteer Experience

List any VOLUNTEER EXPERIENCE you have had.

Experience with Children

What related experience with children have you had? Teaching, babysitting, etc. (include location, dates, ages & gender)

Certifications

Please indicate any CURRENT certifications you have below.
CDA Certification
Standard First Aid
CPR
Other:

Character and References

List 3 people who know of your work such as teachers, employers, etc. No family members, please.

Reference 1
Name:

Physical Address:

Phone:

Reference 2
Name:

Physical Address:

Phone:

Reference 3
Name:

Physical Address:

Phone:

Have you ever been charged, either criminally or civally, with sexual abuse, sexual harassment or discrimination?

Have you ever been convicted of a felony?

If you answered YES to either of the last two questions, please explain.

Activities

Select "LIKE" next to the activites that you like to do. Select "TEACH" next to activities that you could teach or help teach.

Arts & Crafts
Cooking
Gymnastics

Science
Sports
Photography

Music
Singing
Improv/Theatre

Nature
Dance
Carpentry

Other:

Are you available to work weekday mornings?
How did you hear of Purchase Day Camp? If through a friend, who?

The following question is to prevent spam and must be answered correctly to submit the application. The color of a ripe pumpkin is...?