Application for Employment

Sunny Side Child Care Center is committed to a policy of Equal Opportunity Employment and will not discriminate

on any legally recognized basis including, but not limited to, race, age, color, religion, sex, national origin, citizenship,

ancestry, physical or mental disability, veteran status or any other basis recognized by federal, state, or local law.

PERSONAL BACKGROUND (Office Use: _____Resume _____ 3 References Provided _____ Copy of Education _____Background Check)

Date _____/_____/_____

Name____________________________ SS#___________________Last First Middle

Physical Address:_______________________________________________________

Street City State Zip Code

Phone Number: (____) _____- ________ Referred by: _____________

Position Applying For: ___________________________________________________

Date Available to Start: ___/____/____ Full Time: ____ Part Time: _____

Please specify hours of availability:

Mon: ______ Tues: _______ Wed: ______ Thurs: _______ Fri: ______

Are you able, at the time of employment, to submit verification of your legal right to work in the U.S.? Yes ____ No ____

Have you ever been convicted of a felony which is substantially related to the functions or qualifications of the position for which you are applying? Yes _____ No _____

If Yes, please explain: _______________________________________________________

___________________________________________

Do you have an updated (1 year) Medical Physical? Yes ____ No ____Do you have a current CPR and First Aid Card? Yes ____ No ____