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Childcare Employment Applications document sample

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									                                  Campus Crusade for Christ

                                 Application for Employment

Dear Applicant:

This application is specific for summer employment in Fort Collins, Colorado as a childcare worker at Colorado
Kids’ Camp, a licensed childcare center open to the children of Campus Crusade for Christ staff attending various
Campus Crusade conferences and trainings.

Since you have expressed a desire to work with us, we would like to share with you something about the purpose
and work of Campus Crusade for Christ International.

Campus Crusade for Christ is an interdenominational organization whose primary purpose is to present the message
of Jesus Christ to people of all walks of life in every country in the world. We believe that Jesus Christ is the one
person who can change a person from within – who can give meaning, purpose, and direction in life.

In order to accomplish such a ministry, we have people working in many different capacitates such as computer
programmers, office administrators, managers, accountants, receptionists, clerks, electricians, custodians,
housekeepers, and childcare workers.

Campus Crusade for Christ is an equal opportunity employer and abides by Title 7 of the Civil Rights Act of 1964
and subsequent laws which have amended it. We will consider qualified applicants for a specific position without
discrimination because of race, color, sex, national origin, marital status, age or handicap. We also comply with the
Americans with Disabilities Act of 1990.

Please send your completed application to: CSU Childcare, 100 Lake Hart Drive, MC 2100, Orlando, FL 32832 no
later than May 1st, 2009.

Thank you for considering Campus Crusade for Christ as a place to use the skills, knowledge and abilities that God
has given you.

The Colorado Kids’ Camp Leadership Team
Please type or print the answers to the following questions:

Today’s Date ___________________ Date of Birth ______________________________

Name ______________________________________ Email Address ___________________________________

Home phone ________________________________ Alternate Phone__________________________________

Mailing Address ________________________________________________________________________


Permanent Address ______________________________________________________________________


Are you legally eligible for work in the United States? _________ Social Security Number ___________________

Position Desired ________________________________________________________________________

May we consider you for a position other than the one for which you applied? _________

Date available to start ____________________

Have you ever been employed with us? ________ When? ________________________

If yes, what was your position when you were employed by us? ___________________________________

Have you ever been convicted of a felony or a first degree misdemeanor? ____________

If yes, what charges? _____________________________________________________________________

Where convicted? ___________________________________ Date of Conviction: ___________________

Have you ever pled Nolo Contendere or pled guilty to a crime which is a felony or a first degree misdemeanor?

If yes, what charges? _____________________________________________________________________

Where? _____________________________________________Date: _____________________________

Have you ever had the adjudication of guilt withheld for a crime which is a felony or a first degree misdemeanor?

If yes, what charges? _____________________________________________________________________

Where? ______________________________________________ Date: ____________________________

Note: A “Yes” answer to these questions will not automatically bar you from employment. The nature, job
relatedness, severity and date of the offense in relation to the position for which you are applying are considered.
(Please fill out Employment History in its entirety even if your resume is included.)

List your present or most recent employer first and work backward. Please give accurate, complete, full-time and
part-time employment information. If you do not possess all this information, we strongly encourage you to obtain
it for your application materials. Incomplete information may delay or disqualify your application for employment.


Employer _______________________________________Phone _________________________________

Address _______________________________________________________________________________


Employed from: ______________________ To: ______________________________________________

Supervisor’s name _________________________________ Title _________________________________

Position(s) held _________________________________________________________________________

Duties ________________________________________________________________________________


Starting pay rate $____________             Final pay rate $ ______________

Reason for leaving ______________________________________________________________________


Employer ________________________________________ Phone ________________________________

Address _______________________________________________________________________________


Employed from: _______________________ To: _____________________________________________

Supervisor’s name ______________________________ Title ____________________________________

Position(s) held _________________________________________________________________________

Duties ________________________________________________________________________________


Starting pay rate $____________             Final pay rate $ ______________

Reason for leaving ______________________________________________________________________

Employer _________________________________________ Phone _______________________________

Address _______________________________________________________________________________


Employed from: ______________________ To:_______________________________________________

Supervisor’s name _______________________________ Title ___________________________________

Position(s) held _________________________________________________________________________

Duties ________________________________________________________________________________

Starting pay rate $____________    Final pay rate $ ______________

Reason for leaving ________________________________________________________

Are there any previous employers you do not wish us to contact regarding your employment history with them? If
so, please state who and the reasons why:


Please complete the following section carefully providing all requested transcripts, teacher certification (if
applicable) and other documentation. The State of Colorado requires that you document your qualifications. Your
application will be considered incomplete and/or you will receive minimum wage for failure to do so.

Circle the highest grade which you have completed:       High School: 9 10 11 12            College 1 2 3 4 5

Have you graduated from a two or four year college or university? ________________

If yes, please attach a copy of your diploma or an official transcript.

Graduation Year: ______________ Degree: __________________ Major __________________________

If you have taken college level courses in Child Development or Early Childhood Education, please describe below:

Course Title(s)                                  School Name                                Credits Earned




Other Training, certifications or classes taken: (Examples: first aid, CPR, teacher certification, RN, LPN, EMT, etc.
Please attach documentation.)

Which ages of children do you work with best? (rank from 1-7)

______ Infants                      ______ 1st & 2nd grade
______ Toddlers                     ______ 3rd & 4th grade
______ Preschool                    ______ 5th & 6th grade
______ Kindergarten

List any experience you have in working with children. List all work either paid or unpaid, including dates. For
example, Sunday School, teaching preschool, summer camp, daycare, nanny, etc. Please attach additional sheets if

Infant/Toddler Experience:

Preschool Experience:

Lower Elementary Experience:

Upper Elementary Experience:

In addition to anything you have already listed, do you have any special skills or abilities that would be valuable in
working with children? (example: music, dance, art, illusion, juggling, clowning, etc.)

Because of the unique nature and purpose of Campus Crusade for Christ, all employees are required to be involved
in departmental Bible study, ministry training, prayer and worship experiences as part of their job description. In
light of this, the following information is requested as a bona fide occupational qualification.

Please attach a brief statement of your personal relationship with Jesus Christ and how it began.
Church presently attending ________________________________________________________________

City _______________________________ Senior Pastor _______________________________________

What is your present level of church involvement? _____________________________________________


Three written references are required for each applicant. Those completing reference forms must be over 18 years
of age and not related to you. Submit one written reference from each of the following categories:

•   Pastor, Campus Crusade Staff Member or other adult who can comment on your personal maturity and

•   Former employer: if you do not have a former employer, choose another person from #1 above.

•   Any other person of your choice.

Note: Please give one form to each of these people and have them return it to CSU Childcare, 100 Lake Hart Drive,
MC 2100, Orlando, FL 32832 no later than May 1st, 2009.

COPY OF COLLEGE TRANSCRIPTS (downloaded off the web is acceptable)
and TEACHER CERTIFICATION (if applicable)

The following is required for each applicant. When submitted, this will complete the application process. Please
refer to the Checklist for CSU Childcare Worker Application for further details.

•   CCC 2009 Summer Childcare Program Employee Health Review Certificate

•   Proof of Immunizations and a current TB test

•   Identification Originals (required proving work eligibility in the U.S.)

Questions about any part of this application can be sent to


“Any applicant who knowingly or willfully makes a false statement of any material fact or thing in the application is
guilty of perjury in the second degree as defined in Section 18-8-503, C.R.S., and, upon conviction thereof, shall be
punished accordingly.”

Applicant’s signature _______________________________________________________Date ________________
We would like to advise you that we may conduct routine inquiries during the processing of this application that will
provide us with pertinent information concerning your work abilities, character, general reputation and mode of

By my signature below, I authorize each employer and reference that I have listed to release any and all information
in his/her file and possession that would be pertinent to my qualifications for the position for which I have applied
with Campus Crusade for Christ, unless otherwise noted here.

I also declare by my signature below that the statement and information I have provided on this application are true
and accurate to the best of my knowledge and belief. I understand that any intentional omission or misstatement of
fact on this application will be sufficient cause for refusal to employ and//or cause for discharge.

Applicant’s signature _______________________________________________________Date ________________

Colorado State Law requires that you have a Physical Examination within one year to your first day of work.
Please complete this before arrival. We will also be conducting background checks on every applicant who is
hired. Fingerprint cards will be completed after arrival.

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