Employment -

NONDISCRIMINATION POLICY: Kids Village does not discriminate on the basis of race, religion, national or ethnic origin, age, sex, sexual orientation, marital status or disability. All qualified applicants will be considered for available job openings, and final decisions will be based on job related factors.

Applicant Information

Name*

FirstLast

Address*

Street AddressAddress Line 2CityStateZip Code

Home Phone

Business Phone

Social Security Number*

Are you 18 years or older?*

Ethnicity

(Optional. Kids Village is an Equal Opportunity Employer seeking to diversify its workplace.)

Are you legally eligible to work in the U.S.?*

(If hired, you will be asked to produce documentation of your right to work in the U.S..)

Have you ever been convicted of a felony or misdemeanor, including minor traffic offenses that would be considered minor misdemeanors?*

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature, date, circumstances, and relevance of the offense for the position to which you are applying will be taken into consideration. False or incomplete information will be grounds for termination. Your employment is contingent upon satisfactory completion of a background check that is required of all employees.)

If yes, please state the nature of the crime(s), when and where convicted, and disposition of the case(s):*

Position For Which You Are Applying:

Position title

Full-time or Part-time*

Date you can start*

Are you employed now?*

If yes, may we contact your present employer?*

Educational background:

High School/Colleges/Universities name, city, state	Degree earned, and year	Major and minor

Teaching Certificate

Number	Subject	State granting

Work History

Company/School, Name, Address, Phone	Dates Employed, Full Time?, Position/Title	Reason for Leaving

Related Skills and Experience:

Skills, Training and Experience

Teachers: Interdisciplinary teaching, or experience teaching in integrated programs. For All: Special skills, training and experience.

Sports coached

Activities sponsored

Computer literacy

(list equipment and software that you are experienced in using)

Community Service

Currently certified in First Aid?*

Currently certified in CPR?*

Other experiences and skills

Americans with Disabilities Act/Washington Law Against Discrimination Information: Can you perform the essential duties for the position for which you have applied, with or without reasonable accommodation? *

References:

(especially managers and supervisors who have first-hand knowledge of your character, intellectual ability, teaching skills, and kinds of experience listed above)

Reference #1

Name

FirstLast

Position and School/Company

Address

Street AddressAddress Line 2CityStateZip Code

Work Phone

Home Phone

Email

Reference #2

Name

FirstLast

Position and School/Company

Address

Street AddressAddress Line 2CityStateZip Code

Work Phone

Home Phone

Email

Reference #3

Name

FirstLast

Position and School/Company

Address

Street AddressAddress Line 2CityStateZip Code

Work Phone

Home Phone

Email

Reference #4

Name

FirstLast

Position and School/Company

Address

Street AddressAddress Line 2CityStateZip Code

Work Phone

Home Phone

Email

I hereby certify that the information provided on this application is truthful and accurate and that it fairly represents my work history. I understand that omissions or falsehoods on this application may prevent my application from being reviewed. I authorize Kids Village to obtain information about my criminal records, if any, from the Department of Public Safety or other law enforcement agency. I also authorize the school to obtain information from my prior employers and schools, to investigate information provided in my application, and to contact others listed or not listed on my employment application about my work history, education, qualification, or fitness for employment. I release the school and all persons providing information from any liability for obtaining and offering that information, regardless of outcomes.

Signature*

Date

Kids Village Employment Application

Applicant Information

Position For Which You Are Applying:

Related Skills and Experience:

References:

Reference #1

Reference #2

Reference #3

Reference #4