EMPLOYMENT APPLICATION

ST. ANDREW’S PRESBYTERIAN CHILDREN’S PLACE

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION: Today's Date ____________

_________________________________________________________________ __________________

Last Name First Name Middle Initial Social Security #

_________________________________________________________________ __________________

Address City, State Zip Telephone

Email address: __________________________________________________________________________

EDUCATION:

Name of High School _______________________________ Location _________________________

Grades Completed _______________ Graduate? __________ GED? __________ Year _____________

College(s) Attended & Location Dates # Hours Grade Point Degree(s)

(Attach transcripts if available) Attended Completed Average Earned

_______________________________ ________________ __________ __________ _____________

List any specific courses, major/minor areas of study or extracurricular activities which you feel

have prepared you for work with young children.

__________________________________________________________________________________________

List any additional training or vocational courses you have completed or professional certificates you may have.

__________________________________________________________________________________________

RECORD OF PREVIOUS EMPLOYMENT:

Please complete the following information on your last three positions of employment, beginning

with the most recent first.

_______________________ ______________________ __________________________ ______________

Employer City, State Supervisor's Name Telephone

_______________________ _____________________ ______________________ ___________________

Position Held Hourly Rate/Salary Dates of Employment Reason for Leaving

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_______________________ _______________________ __________________________ _____________

Employer City, State Supervisor's Name Telephone

_______________________ _____________________ _______________________ __________________

Position Held Hourly Rate/Salary Dates of Employment Reason for Leaving

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_______________________ _______________________ __________________________ _____________

Employer City, State Supervisor's Name Telephone

_______________________ _____________________ _______________________ __________________

Position Held Hourly Rate/Salary Dates of Employment Reason for Leaving

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REFERENCES:

Please list three persons not related to you, who have first hand knowledge of your character, personality,

scholarship, experience and ability to work with young children.

Name Address Telephone

____________________________ _______________________________________ ___________________

QUALIFICATIONS:

Are you over 18 years old? ________ Are you legally authorized to work in this country? ________

For what position do you wish to apply? ________________________________________________________

Please circle your preference: Full Time (40 hrs.) School Day (30 hrs.) Part-Time (T/Th or M/W/F)

Why would you like to have this position? ___________________________________________________

__________________________________________________________________________________________

What three qualities do you possess that you would bring to this position? _____________________

__________________________________________________________________________________________

Are there other positions you would like to be considered for? _______________________________

What is your biggest pet peeve when it comes to children? ___________________________________

__________________________________________________________________________________________

What do you feel is most important in dealing with parents and staff? __________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

What is your philosophy of early childhood education? _______________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________
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I certify that answers given by me on this application are true and complete to the best of my knowledge.

I authorize the investigation of all statements contained in this application as may be necessary in arriving at

an employment decision. I consent to the disclosure of any and all information about me by any prior employer,

schools or references. Any misleading or inaccurate information given in this application or interview will result

in my not being considered for employment and/or termination of employment from St. Andrew's Presbyterian

Church if I have been employed.

Prior to commencing employment with St. Andrew's, I understand that I must provide verification of my identity,

education and authorization to work in the United States of America according to the provisions of the Immigration

Reform and Control Act.

I certify that I have never been convicted of (1) a felony or misdemeanor classified as an offense against the person

or family; (2) a felony or misdemeanor classified as public indecency; or (3) a felony violation of any law intended

to control the possession or distribution of any substance included as a controlled substance under the Texas

Controlled Substance Act. In addition, I have never been convicted or placed on deferred adjudication for any

felony or misdemeanor and there are no pending criminal charges against me.

If I am employed by St. Andrew's Presbyterian Church, I agree to abide by all rules and policies of St. Andrew's and

all applicable rules and regulations of governing state agencies. If hired, I understand my employment may be subject

to an employment contract and that this application is not a contract of employment.

__________________________________________ ________________________

Signature of Applicant Date

8/03

St. Andrew’s Presbyterian Children’s Place in Houston, Texas, will recruit, hire, train and promote qualified persons

in all job classifications without regard to race, color, creed, sex, age, national origin, or disabilities.