Employment Sanders Acedemy For Excellence Employment Application Applicant Information First, Middle, & Last Name Street Address Apt/Unit # City State Zip Code Phone # Email Address Date available to begin work Availability Social Security # D.O.B. Are you a citizen of the United States? YES NO - If no, are you authorized to work in the U.S? YES NO Have you ever been convicted of a felony? YES NO If yes, please explain Education/Child Care Experience High School City State Dates attended (Month/Year) To Did you graduate? YES NO Degree Obtained College CITY STATE Dates attended (Month/Year) To Did you graduate? YES NO Degree Obtained Other City State Dates attended (Month/Year) To Did you graduate? YES NO Degree Obtained References Please list three professional references. 1. Full Name Relationship Company Phone # Address 2. Full Name Relationship Company Phone # Address 3. Full Name Relationship Company Phone # Previous Employment 1. Company Phone # Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? YES NO 2. Company Phone # Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? YES NO 3. Company Phone # Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? YES NO Other What do you feel most qualifies you for a position at our center? What are your professional goals? Disclaimer & Signature Acceptance I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Date Send Message Our Address & Contact Details Address Sanders Academy for Excellence 2225 Cumberland Avenue Waco Texas, 76707 Phone & Email (254) 339-1135 safechildcare7@gmail.com Childcare Hours Monday – Friday 7:00AM – 5:30PM Weekend Closed