EmailMe Form - Bounce Application

EmailMeForm

Today's Date
MM / DD / YYYY
Start Date:
When are you available?
Name
First Last
Birthday
MM / DD / YYYY
Address

Street Address City State / Province / Region Postal / Zip Code Country / Region
Phone Number
### - ### - ####
Your Email *
Parent's Names
Parent's Phone Number
### - ### - ####
Parent's Email *
Preferred Salary
Number of hours
What school ?
What year?
How did you hear about Bounce-n-Play?
Word of mouth, from whom?
Part of our application process requires access to your Facebook page, are you willing to do that?
Yes
No
Employment History:
Employer name

Address/Phone number

Job Title/duties

Dates employed from / to
Employer name

Address/Phone number

Job Title/duties

Dates employed from / to
References: List two professional or personal references who are not relatives
Reference 1.
First Last
Number of years known
Street Address City State / Province / Region Postal / Zip Code Country / Region
Phone
### - ### - ####
Reference 2.
First Last
Number of years known
Street Address City State / Province / Region Postal / Zip Code Country / Region
Phone
### - ### - ####
By submitting this application you are agreeing to give Bounce-n-Play of Charlottesville permission to do a thorough background check, credit check and drug screen prior to employment. As part of our processing your application your personal and employment references will be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. If you are hired you must supply your birth certificate or other proof of authorization to work in the US and are subject to random drug screening.
Have you ever been convicted of a felony, barrier crime or subject of a founded child protective services complaint?
If yes, explain
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Employment History:

References: List two professional or personal references who are not relatives