Northside Child Development Center

A ministry of

Application Date:

Date available to start work:

Staff Application

Thank you for your employment interest at the Northside Baptist Church Child Development Center. Please fill out the application and return to our Childcare office. If we have a position open that would match your qualifications we will contact your references. If we have continued interest in your application, we will call you to set up a personal interview. Please understand that by filling out this application, you are not being guaranteed employment.

We realize that the key to a successful Christian childcare ministry is the staff. We are grateful for those who are professionally qualified, who really love children and who, by the pattern of their lives, are Christian role models.

We look forward to receiving your initial application. Again, thank you for your interest in a position at Northside Baptist Church Child Development Center as we provide quality childcare to our community.

Personal Information

Full Legal Name:

(First Name) (Middle Initial) (Last Name)

Address:

(Street Address)

(City) (State) (Zip)

Home Phone Number: Cell Number

E-Mail

Availability

We are open 6:00 a.m. to 6:00 p.m. Monday through Friday. Please state your availability for the following:

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Monday

Tuesday

Wednesday

Thursday

Friday

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Spiritual

Do you attend church regularly? Yes No Where?

State briefly your Christian experience:

Christian work and experience you have been a part of:

Educational Background (Circle item to indicate highest grade completed)

High School – 1 2 3 4 GED College (Undergraduate) – 1 2 3 4

College Degree:

Graduate Degree:

Other Special Training (please specify):

Physical Record

Are there any physical or personal limitations on the type of work you can do with

children?

Employment Experience (during last ten years)

Name of Employer:

Dates of Employment Phone:

Address:

(Street Address)

(City) (State) (Zip)

General Duties:

Name of Employer:

Dates of Employment Phone:

Address:

(Street Address)

(City) (State) (Zip)

General Duties:

Why are you applying at Northside for employment?

Describe your experience working with children:

Do you have children who will need to attend the center while you are working?

Y N

Name Birthdate

Name Birthdate

Name Birthdate

References (relative references cannot be accepted)

Name: Phone:

Relationship:

Name: Phone:

Relationship:

Name: Phone:

Relationship:

Emergency Contacts

Name: ______Phone:

Relationship

Name: ______Phone:

Relationship

I authorize the prospective employer to inquire as to my record of all or any persons and/or former employers. In the event of my employment with the Northside Baptist Child Development Center, I agree to comply with the rules and regulations governing my employment. It is my understanding that the first three months of my employment are probationary, and if my services do not prove satisfactory, my employment may be discontinued on a weeks notice without prejudice.

Applicant Signature: ______Date:

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