Customer Service/Afterschool Elementary Instructor

Name *
First *
Last *
Home Address: *
Position # that you are applying for: *
Email *
Cell Phone Number *

How did you hear about us?
Desired Pay Rate *
When are you available to start? *

Transportation: If hired, would you have a reliable means of transportation to and from work? (Explain) *
Check the following boxes if you have regular access to: *
Can you lift 35lbs? *
This job does require some driving of your personal car to elementary school sites in order to sub. You will be reimbursed for any mileage. Number of miles is negligible, however, is this something that works for you? *
Tell us about yourself: *
Please summarize your prior experience with children: *
Why do you think you would be the ideal candidate? *
What do you see yourself doing 2 years from now: *
List your qualifications for excelling in an office environment. *
Current Employment, Position & No. of Years: *
Highest level of education completed: *
College Information (if applicable): *
Indicate school, major & current students indicate
expected graduation date:
Are you at least 18 years old?
US Citizenship:
If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?
Have you ever been convicted of a criminal offense (felony or misdemeanor)?
DO NOT answer YES if your conviction (felony or misdemeanor) involved marijuana and is more than 2 years old. DO NOT answer YES or provide any information regarding referral to and/or participation in any pre-trial or post-trial diversion program.


Please list 2 references; include at least one professional reference.
Reference #1 *
Include name, phone number, and relationship
Reference #2 *
Include name, phone number, and relationship
Employee’s Agreement: I am aware that a consumer report and/or an Investigative consumer report may be requested in connection with my application for employment. If such a report is requested, and in response to a written request from me, you will inform *
 Do Not Accept 
Image Verification
Please enter the text from the image:
[Refresh Image] [What's This?]
Powered byEMF Online Form Builder
Report Abuse