Child Care Teacher

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Please complete the form below to apply for this position.

* First Name:
* Last Name:
Address:
* City:
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* Phone Number:
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* How did you become aware of this position?
Preferred Location(s) of Employment (Check All That Apply):
The Pulaski Center
Administrative Office
Bellin Health Center
Carol Bush Center
Central Kitchen
Ruth Helf Children's Learning Center
De Pere Center
The Cornerstone Center
The Rosebush Center
* Are you legally eligible for employment in the United States?
* Are you over 18 years of age?
* Availability To Work:
* First Date Available To Begin Work:
* Indicate Times and Days You Are Available To Work:
* Have you previously applied for employment with Encompass Early Education and Care?
If yes, list month, year and location:
* Salary Requirement:
* Select All Education Levels That Apply (Completed and/or Enrolled In a Qualified Program):
High School Diploma/GED
Post High School Certificate
Associate Degree
Bachelor's Degree
Master's Degree
Currently Enrolled In a Post High School Program and Working Toward A Degree
Major/Field of Study:
School Name(s):
* Describe any specialized training, skills and other job-relevant activities that may be helpful for us to consider:
Past Employer #1 Company Name:
Company Address:
Position Held:
Company Phone Number:
Supervisor Name:
Employment Dates:
Description of Responsibilites and Duties:
Starting Rate Of Pay:
Final Rate Of Pay:
Reason for Leaving:
Explanation:
OK To Contact?:
Yes
No
If No, Please Explain:
Past Employer #2 Company Name:
Company Address:
Position Held:
Company Phone Number:
Supervisor Name:
Employment Dates:
Description of Responsibilites and Duties:
Starting Rate Of Pay:
Final Rate Of Pay:
Reason for Leaving:
Explanation:
OK To Contact?:
Yes
No
If No, Please Explain:
Past Employer #3 Company Name:
Company Address:
Position Held:
Company Phone Number:
Supervisor Name:
Employment Dates:
Description of Responsibilites and Duties:
Starting Rate Of Pay:
Final Rate Of Pay:
Reason for Leaving:
Explanation:
OK To Contact?:
Yes
No
If No, Please Explain:
* Professional Reference #1 Name:
* Employer/Position:
* How Acquainted:
* Years Known:
* Email:
* Phone Number:
* Professional Reference #2 Name:
* Employer/Position:
* How Acquainted:
* Years Known:
* Email:
* Phone Number:
* Professional Reference #3 Name:
* Employer/Position:
* How Acquainted:
* Years Known:
* Email:
* Phone Number:
Voluntary Equal Opportunity Questionaire Gender:
Ethnic Origin:
Disability:
Not Disabled
Disabled
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Veteran Status:
None
Disabled Veteran
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Armed Forces Service Medal Veteran
Recently Separated Veteran
* The information provided in this application for employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application my result in dismissal:
I Agree
I Disagree
* I am aware that eligibility for employment at Encompass Early Education and Care is determined in part by criminal background check:
I Agree
I Disagree
* I certify that I have never have been convicted of child abuse or crimes against sexual morality involving children:
I Agree
I Disagree
* I hereby authorize my former and present employers and referances listed to disclose information regarding me and/or my employment:
I Agree
I Disagree
* I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future:
I Agree
I Disagree
* Full Legal Name (Electonic Signature):
* Date (MM/DD/YYYY):
* Required Field

Equal Opportunity Employer
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