Graphic Design Request 2.0

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Name*

First Name

Last Name

Cell Phone*

Home Phone

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Your Résumé*

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Acceptable file types: pdf,doc,docx

How did you hear about this position?*

Who was the person who told you about this position?*

Please describe how you find out about this opportunity:*

Have you previously worked at this JCC before?*

Yes No No, but I have worked at a different JCC.

Name of JCC:*

Job Position(s):*

Reason for Leaving:*

Personal Information

Are you over the age of 18?*

Yes No

Date of Birth*

Position I'm Applying For:*

Early Childhood Lead Teacher Early Childhood Assistant Teacher Early Childhood Full-Time Substitute Early Childhood Support Staff Lead and Assistant Infant/Toddler Teachers

Which age group(s) do you prefer working with?*

Which age group(s) do you prefer working with?
	1st Choice	2nd Choice	3rd Choice	4th Choice	5th Choice
Younger than 2	Which age group(s) do you prefer working with?: Younger than 2 (1st Choice)	Younger than 2 (2nd Choice)	Younger than 2 (3rd Choice)	Younger than 2 (4th Choice)	Younger than 2 (5th Choice)
2-Year-Olds	2-Year-Olds (1st Choice)	2-Year-Olds (2nd Choice)	2-Year-Olds (3rd Choice)	2-Year-Olds (4th Choice)	2-Year-Olds (5th Choice)
3-Year-Olds	3-Year-Olds (1st Choice)	3-Year-Olds (2nd Choice)	3-Year-Olds (3rd Choice)	3-Year-Olds (4th Choice)	3-Year-Olds (5th Choice)
4-Year-Olds	4-Year-Olds (1st Choice)	4-Year-Olds (2nd Choice)	4-Year-Olds (3rd Choice)	4-Year-Olds (4th Choice)	4-Year-Olds (5th Choice)
5-Year-Olds (Pre-K)	5-Year-Olds (Pre-K) (1st Choice)	5-Year-Olds (Pre-K) (2nd Choice)	5-Year-Olds (Pre-K) (3rd Choice)	5-Year-Olds (Pre-K) (4th Choice)	5-Year-Olds (Pre-K) (5th Choice)

Type of Employment Preferred:*

Full-Time Part-Time Substitute/Occasional

Please specify availability:*

If you are offered employment, when are you available to begin work?*

If hired, are you able to submit proof that you are legally eligible for employment in the US?*

Yes No

What are your strengths and why do you think you would be the best candidate for this position?*

Any hobbies, recreational interests, or special talents you would like to share?

Are you able to perform the essential functions of the job for which you are applying, with or without an accommodation?*

Do you speak any languages fluently other than English?*

Yes No

Languages:*

Have you ever been convicted of a misdemeanor or felony?*

Yes No

The existence of a criminal record does not constitute an automatic bar to employment.

Please provide the details (including offense, date, and disposition):*

Do you object to being fingerprinted?*

Yes No

Previous Work Experience

Do you have at least 3 previous employment positions to share with us?*

Yes No

I can share:*

Employer #1

Business Name*

Position*

Supervisor's Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Dates Worked*

Reason for Leaving*

Employer #2

Business Name*

Position*

Supervisor's Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Dates Worked*

Reason for Leaving*

Employer #3

Business Name*

Position*

Supervisor's Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Dates Worked*

Reason for Leaving*

Would you like to list any non-family references in addition to the supervisors listed above (optional)?*

Yes No

Additional References

Reference #1

Name

First Name

Last Name

Business Name

Phone

Relationship to You

Reference #2

Name

First Name

Last Name

Business Name

Phone

Relationship to You

Reference #3

Name

First Name

Last Name

Business Name

Phone

Relationship to You

Emergency Contact

In an emergency, please notify:

Name*

First Name

Last Name

Relationship to You*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Cell Phone*

Home Phone

JCC Employment Policies

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorize the JCC to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information to the JCC regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information to the JCC regarding my previous employment and education.

If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by the Chief Executive Officer or Executive Director, the employment relationship will be “at-will.” In other words, the relationship will be entirely voluntary in nature, and either I or the JCC will be able to terminate the employment relationship at any time, with or without cause. Moreover, no agent, representative, or employee of the JCC, except in a specific written contract of employment signed on behalf of the organization by the Executive Director, has the power to alter or vary the voluntary nature of the employment relationship.

It is my understanding that the first three months of employment are probationary, and if my services have not proved satisfactory, my employment may be terminated.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.*

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Personal Information

Educational Background & Professional Experience

Previous Work Experience

Employer #1

Employer #2

Employer #3

Additional References

Reference #1

Reference #2

Reference #3

Emergency Contact

JCC Employment Policies

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.