Application | Village Tree

Application For Employment

Today's Date

General Information

First Name

Middl Initial

Last Name

Street Address

City

Region/State/Province

Postal / Zip code

Phone with Area Code

Employment Information

Are you at least 18 years old?

Yes

Date available to start work:

Number of Hours Per Week Desired:

Anticipated Salary:

Have you ever applied to work for or been employed by Village Tree?

Yes

If yes, when and where?

Why did you leave?

Experience (Start with the most recent experience) The following people may be contacted by Village Tree

1. Company Name

Position Held

Name of Supervisor

Address

Phone

Reason For Leaving

Start Date

End Date

Start Salary

End Salary

2. Company Name

Position Held

Name of Supervisor

Address

Phone

Reason For Leaving

Start Date

End Date

Start Salary

End Salary

3. Company Name

Position Held

Name of Supervisor

Address

Phone

Reason For Leaving

Start Date

End Date

Start Salary

End Salary

Education

High School Attended

City/State

Course of Study

Year Completed

Degree

College Attended

City/State

Major

Year Completed

Degree

Other (i.e., CDA, Graduate School)

City/State

Major

Year Completed

Degree

Village Tree takes affirmative action to comply with all applicable laws of local, state and federal governments regarding employment practices which prohibit discrimination in employment based on race, religion, color, sex, age, national origin, disability or other characteristics protected by the law.

Have you ever been discharged or forced to resign from a position?

Yes

If yes, explain:

A childcare position in a childcare center/school may be physically and emotionally demanding. The demands include, among other things, the need to lift and carry children on a regular basis and the need to react quickly, at all times, to any emergency situations. Are you able to fulfill these functions of the job, with or without reasonable accommodation?

Yes

(Note: Although such conditions are not a bar to employment, an accurate response is important for your safety as well as that of other individuals at the work place, and may be necessary for the Company to determine whether a reasonable accommodation, if appropriate, can be made.)

In order to determine my suitability for employment at Village Tree, I authorize Village Tree to contact any references or other private or public sources to obtain personal background information regarding myself. All final candidates being considered for a position with Village Tree will be required to complete a Criminal Background Check in accordance with Village Tree's Policy. I further authorize Village Tree to (a) review any informational databases (including any registries in any state) maintained for the purpose of screening employees (b) conduct any appropriate criminal background investigations required or permitted by local, state and/or federal law, and (c) review any social networking sites, communities, blogs, wikis or other on-line resources in which I am identified. I understand that the results of such reviews and investigations may be used by Village Tree to determine in its sole discretion my continued suitability for employment at Village Tree at any time. I hereby certify that all facts and information listed on this application are true and complete. I understand that any false, incomplete or misleading information given by me on this application may result in rejection of this application at any time even after I am employed and may result in my immediate dismissal. I hereby release and forever discharge Village Tree, its agents and employees, from any and all liability of every kind and description incurred by virtue of conducting an investigation into my personal history, background, or character traits, including the matters set forth in the Village Tree Criminal Background and Educational Form.

In order to determine if I have characteristics which qualify me to work effectively with children or otherwise determine my suitability for employment at Village Tree, I hereby authorize Village Tree to contact any references or other privates or public sources to obtain my personal background information. I hereby certify that all facts and information listed on this reference request form are true and complete. I understand that any false, incomplete or misleading information given by me on this reference request form may result in rejection of my application for employment at any time even after I am employed and may result in my immediate dismissal.

I have read and agree to the foregoing.

EQUAL EMPLOYMENT OPPORTUNITY DATA FORM

IMPORTANT - To All Applicants: To enable us to meet government reporting regulations and maintain an Affirmative Action Plan, Village Tree requests that you complete this personal data form. Information will be used solely for government reporting purposes and will be detached and kept separate from your application. Any information that you choose to provide will not be considered by Village Tree for employment purposes and will be treated as personal and confidential. Your voluntary cooperation will be appreciated.

Name (Last, First, Initial)

Date

If you do not wish to complete this form,

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Please choose:

Male

Female

If any of these definitions apply to you, please check off the appropriate line(s) to be considered under our Affirmative Action Plan.

Please Describe

Thanks for applying! We'll get back to you soon.

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Welcome to Village Tree at Pecan Way

Application For Employment

General Information

Employment Information

Experience (Start with the most recent experience) The following people may be contacted by Village Tree

Education

EQUAL EMPLOYMENT OPPORTUNITY DATA FORM

License #: 1762173 (Pecan Way)

Tel: 281-302-5389

Tel: 281-302-5080

Pecan Way at Village Tree

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