DCELC Employment Application

Date

Any medical concerns our team needs to be aware of?

Check all that apply.

Check all that apply.

EDUCATION

Please fill out all that apply. You may be asked to submit transcripts or diplomas upon request.

Name of School, Date Graduated, Major/Program

Name of School, Date Graduated, Major/Program

Name of School, Date Graduated, Major/Program

EMPLOYMENT HISTORY

REFERENCES

Please list three references.

Please list the references Name, Phone Number, and Relationship to You

Please list the references Name, Phone Number, and Relationship to You

Please list the references Name, Phone Number, and Relationship to You

VALIDATION

I certify that the information provided on the application is true and accurate. I authorize Dunnville Childcare and Early Learning Center to verify the information and I waive any right to confidentiality. I specifically authorize the following: criminal records check, child abuse or neglect check, verification of employment, and reference checks.
Date

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