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Name:
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Email Address:
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Phone:
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Home Address:
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City, State, Zipcode:
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Position applying for:
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I am applying for Full Time Work
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I am applying for PartTime Work
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I am applying for Summer Work
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What days and hours are you available to work?
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Are you available to work on weekends?*
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If hired, on what date can you start work?*
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Salary Desired:*
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What geographical area would you be able to work in?
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PERSONAL INFORMATION
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Have you ever applied to work for Love 2 Learn Consulting LLC before? If yes, when?*
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Do you have any friends or relatives working for Love 2 Learn Consulting? If so, please list name and relationship.:*
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If hired, would you have a reliable means of transportation to and from work?*
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Do you possess a valid driver's license?*
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If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?:*
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Have you ever been convicted of a criminal offense (felony or serious misdemeanor)? (Misdemeanor convictions for marijuana-related offenses that are more than two years old need not be listed.) If yes, state nature of the crime(s), when and where convicted, and disposition of the case.
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)*
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Are you currently employed?*
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If so, may we contact your current employer?*
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EDUCATION, TRAINING, AND EXPERIENCE
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High School Name:
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High School Address, City, State, Zip:*
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High School- Did you graduate?*
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High School- Number of years completed:*
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College/University- Name:*
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College/University- Address, City, State, Zip:*
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College/University- Did you graduate?:
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College/University- Name of Degree or Diploma:
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Additional Education- Name:
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Additional Education- Address, City, State, Zip:
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Additional Education- Did you graduate?
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Additional Education- Name of Degree or Diploma:
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Do you have experience working with children who have disabilities? If so, please tell us about it.
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Please describe any volunteer or life experience that may be applicable for the position for which you are applying.
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Some of our clients do not speak English.Do you speak, write or understand any foreign language? If yes, which language(s)?
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EMPLOYMENT HISTORY
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List below all present and past employment starting with your most recent employer (last five years is sufficient). Account for all period of unemployment. You must complete this section even if attaching a resume.:
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Name of Employer:*
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Telephone No.:*
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Address, City, State, Zip:*
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Dates of Employment From______ to _____:*
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Pay Rate Starting and Ending (per hour or per year):*
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Your Position and Duties:*
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Reason for Leaving:*
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May we contact this employer for a reference?*
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Name of Employer:*
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Telephone No.:*
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Address, City, State, Zip:*
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Dates of Employment From______ to _____:*
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Pay Starting and Ending:*
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Your Position and Duties:*
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Reason for Leaving:*
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May we contact this employer for a reference?*
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Name of Employer:
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Telephone No.:
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Address, City, State, Zip:
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Dates of Employment From______ to _____:
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Pay Starting and Ending:
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Your Position and Duties:
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Reason for Leaving:
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May we contact this employer for a reference?
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Name of Employer:
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Telephone No.:
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Address, City, State, Zip:
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Dates of Employment From______ to _____:
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Pay Starting and Ending:
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Your Position and Duties:
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Reason for Leaving:
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May we contact this employer for a reference?
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REFERENCES
Please be sure to only list professional references
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Name:*
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Telephone Number:*
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Address, City, State, Zip:*
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Occupation:*
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Number of years acquainted:*
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Name:*
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Telephone Number:*
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Address, City, State, Zip:*
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Occupation:*
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Number of years acquainted:*
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Name:
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Telephone Number:
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Address, City, State, Zip:
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Occupation:
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Number of years acquainted:
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Please Read Carefully, Initial Each Paragraph
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I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.: *
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I hereby authorize Love 2 Learn Consulting to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.: *
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I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the Company unless made in writing and signed by me and the Company's designated representative.: *
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Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records obtained by the Company unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.: *
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I waive receipt of a copy of any public record described in the paragraph above.*
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To be dated and signed at interview.
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