Please answer all questions completely. We are an Equal Opportunity Employer. No question on this application is intended to be discriminatory under any applicable Federal, State or Local Fair Employment Practices Law. All employment offers are contingent upon proof of your legal right to work in the U.S. and your ability to pass a criminal background clearance from the state of California.

Personal Information

Name

Phone Number

Address

City, State and ZIP Code

Are you able to provide proof of your eligibility to work in the USA?

Social Security Number

If under age 18, do you have a work permit?

Have you ever worked under a different name?

Employment Interest

What position are you interested in applying for?

Date Available

Type of Employment

Regular
Temporary
Full Time
Part Time

Shift Desired

7am - 9am
9am - Noon
Noon - 6pm
Regular School Day
7:45am - 4:15pm

If hired, would you have reliable transportation to and from work?

If required for the position, do you have a valid driver’s license?

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

Education Information

Education

High School
Business/Technical School
College
Graduate Work

Degree

Some College
AA Degree
BA Degree
Valid California Teaching Credential

Additional Skills & Training Information

List any specialized training or courses you have completed which will aid in evaluating your qualifications for the position you are seeking. If applying for a teaching/teaching aide position, list all additional courses of study or training earned in early-childhood education, child development, and elementary education with the dates completed.

Number of College Early Childhood Education units

List all additional courses of study or training earned in early childhood education, child development, and elementary education with the dates completed.

Do you have a current Child Care CPR/First Aid Certification?

If yes, when does it expire?

Do you have a valid California State Teaching Credential?

Is your California State Teaching Credential cleared?

PLEASE ATTACH YOUR COLLEGE TRANSCRIPTS SHOWING ECE UNITS COMPLETED and/or TEACHING CREDENTIAL

College Transcripts

Browse

Teaching Credential

Browse

Employment Information

Please list individuals who are able to provide references regarding your work habits and your abilities

Employer Name

Employer Phone Number

Employer Address

City, State and ZIP Code

From (mo/yr)

To (mo/yr)

Job Title

Duties

Supervisor Name

Supervisor Title

May we contact this employer?

Reason for leaving

Employer Name

Employer Phone Number

Employer Address

City, State and ZIP Code

From (mo/yr)

To (mo/yr)

Job Title

Duties

Supervisor Name

Supervisor Title

May we contact this employer?

Reason for leaving

Employer Name

Employer Phone Number

Employer Address

City, State and ZIP Code

From (mo/yr)

To (mo/yr)

Job Title

Duties

Supervisor Name

Supervisor Title

May we contact this employer?

Reason for leaving

Professional References

Please list individuals who are able to provide references regarding your work habits and your abilities.

Reference Name

Phone Number

Relationship to You

Years Known

Reference Name

Phone Number

Relationship to You

Years Known

Reference Name

Phone Number

Relationship to You

Years Known

Previous Addresses

If you have lived at your current address for less than seven years, please provide information on all addresses during that period.

Previous Address

City, State and ZIP Code

From

Address

City, State and ZIP Code

From

Address

City, State and ZIP Code

From

Church History

Do you actively attend church?

From (mo/yr)

To (mo/yr)

Do you have a personal relationship with Jesus Christ?

Have you been baptized in water?

PLEASE LIST ALL CHURCHES YOU HAVE ATTENDED CONSISTENTLY IN THE PAST

Church Name

Pastor's Name

Church Phone Number

Address

City, State and ZIP Code

Date Range

Church Name

Pastor's Name

Church Phone Number

Address

City, State and ZIP Code

Date Range

Applicant’s Certification and Agreement

I understand that Destiny Christian Church and Destiny Christian Preschool do not discriminate in its employment practices against any person because of race, color, national or ethnic origin, sex, age or disability. I hereby certify that the facts set forth in this initial application are true and complete to the best of my knowledge. I understand that discovery of falsification of any statement or a significant omission of fact may prevent me from being hired, or if hired, may subject me to immediate dismissal regardless of the time elapsed before discovery. If I am released under these circumstances, I further understand that I will be paid, and receive benefits, only through the day of release. I authorize any person, school, current employer (except as expressly noted), past employer (s), and organizations named in this application form (and accompanying resume or other documentation, if any) to provide Destiny Christian Church and Destiny Christian Preschool with relevant information and opinion, personal or otherwise, that may be useful in making a hiring decision. I release all parties from all liability for any damage that may result from furnishing information and opinion to you. I further authorize those given as references and my former employers to disclose to Destiny Chris-tian Church and Destiny Christian Preschool any and all employment records, performance reviews, letters, reports, and other information related to my life and employment, without giving me prior notice of such disclosure. I waive the right to ever personally view any reference given to Destiny Christian Church and Destiny Christian Preschool. I understand that this is only an application for employment and that no employment contract is being offered at this time. I understand that all offers of employment are contingent upon my providing satisfactory documentary proof of my identity and legal right to live and work in the United States. I hereby acknowledge that I have read the above statements and understand them. I certify that I, the undersigned applicant, have personally completed this application

I, the undersigned, agree to the terms above.