FUMC LEARNING CENTER Like our Facebook Page! EMPLOYEE APPLICATION Name * First Name Last Name Application Date * MM DD YYYY Address Address 1 Address 2 City State/Province Zip/Postal Code Country Gender * Male Female Age * Date of Birth * MM DD YYYY Marital Status * Cell Phone * (###) ### #### Alternate Phone Number * (###) ### #### Email * Position Desired * Family Record: Spouse Name First Name Last Name Employed By Spouse Cell (###) ### #### Work Phone (###) ### #### Children: (List names and ages) In Case of Emergency, please notify: * Include Name, Address, and Phone Number EDUCATION Did you attend and complete Elementary School? * Yes No Please List the Name and City, State of Your School attended. Did you attend High School? * Yes No Please List the Name and City, State of your school attended. Did you Receive a High School Diploma? * Yes No No, I received my GED or equivalent. Did You Attend College? * Yes No Please List the Name and City, State of your school attended. Please list any degrees, certificates received. * WORK EXPERIENCE Use the Area below to list all Work Experience. * Please include dates employed, employer name, position, salary, and reason for leaving. I give FUMC Learning Center permission to contact my previous employers for the first five years to secure recommendations with regard to any past criminal records, mental or physical conditions that would adverse affect my capability to work with or to provide care for children. * Yes No Please Use the Area Below to provide references. (Please list no relatives) Work Reference * Please include Name, Address, and Telephone Number Education Reference * Please include Name, Address, and Telephone Number Character Reference * Please include Name, Address, and Telephone Number Volunteer Experience List any volunteer work that you have done with children Any Special Gifts, Talents, or certifications? Write a short paragraph telling why you are interested in this position, and what you think would be expected of you. * Thank you!
