Employment Screening Application
* Full Name:
* Address:
* City:
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* Zip:
* Day Phone:
Evening Phone:
Email:
Best Contact Time:
*How did you hear about us?

* What position(s) are you interested in?
	Infant/toddler Teacher
	2yr/3yr Teacher
	4yr/5yr Teacher
	Schooler Teacher
	Van Driver
	Cook
	Assistant Director
	Qualified Center Director
* What location are you interested in?
	BURLESON CLEBURNE CROWLEY EULESS GRAPEVINE - N. EULESS HALLMARK MEADOWBROOK- HANDLEY NORTH BEACH UPTOWN (DOWNTOWN) HURST NORTH RICHLAND HILLS - WATAUGA (Grapevine HWY) NORTH RICHLAND HILLS - WATAUGA (Smithfield RD) RICHLAND HILLS WEATHERFORD
Interests:
	FullTime
	Part Time
	Substitute
	Seasonal
	Summer Only
* Education: (check highest level completed)
	High School Diploma
	1-30 College credits
	31 - 59 College Credits
	Associates Degree
	Child Development Assoc (CDA)
	Bachelors Degree
	Masters Degree
	Doctoral Degree
Degree completed in (Year):
* Are you currently working in the child care field?
	Yes No
If yes, how many years of experience in child care?	< 6 months < 1 year 1-2 years 2-3 years 3-5 years 5-10 years 10-15 years > 15 years
Current Occupation:
Are you CPR/First Aide certified?
	Yes No
* Experience/Qualifications:
Other Information:
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