Little Anchor Employment Application

Little Anchor does not discriminate in its hiring practices on the basis of race, religion, sex, national origin, creed, color, sexual orientation, citizenship, veteran’s status, age, disability, or marital status.

If accepted for employment and before you begin working, you must provide proof of a negative TB test. Proof of identity, US Citizenship or current work visa is also required. Employment is conditioned on the completion of the Washington State and Federal background authorization forms which may include fingerprinting.

Name

First Name

Last Name

Phone

(###)

###

####

Position for which you are applying

Infant Teacher (0-1yr)

Toddler Teacher (1-2yrs)

Junior Room Teacher (2-3yrs)

Preschool Teacher (3-5yrs)

Team Teacher (0-5yrs)

Are you at least 18 years of age?

Yes

Have you ever been arrested?

Yes

If yes, what for and when?

When can you report for work?

YYYY

EDUCATION

High School & Graduation Year

College/University & Graduation Year or Years of Attendance

List Other Diplomas or Certifications

EMPLOYMENT HISTORY

Starting with current or most recent employer

1. Employed By

Position

Supervisor

Hourly Rate

Dates of Employment

Month/Year to Month/Year

Reason for Leaving

2. Employed By

Position

Supervisor

Hourly Rate

Dates of Employment

Month/Year to Month/Year

Reason for Leaving

3. Employed By

Position

Supervisor

Hourly Rate

Dates of Employment

Month/Year to Month/Year

Reason for Leaving

PROFESSIONAL REFERENCES

Reference #1

First Name

Last Name

Employer and Occupation

Phone

(###)

###

####

Reference #2

First Name

Last Name

Employer and Occupation

Phone

(###)

###

####

Reference #3

First Name

Last Name

Employer and Occupation

Phone

(###)

###

####

Is there anything else you would like to say or for us to know?

By clicking "SUBMIT" I authorize Little Anchor to inquire as to my record of any or all persons of my former employers. In the event of my employment, I agree to comply with the rules and regulations governing my employment. I have been informed that Little Anchor requires fingerprinting.

It is my understanding that the first 30 days of my employment is provisional, and if my job performance has not proved satisfactory, my employment may be discontinued without prejudice.

All information I have provided is true and I understand that providing false information may result in rejection of my application or dismissal at any time if I am hired.