*Applicant Name:

Date:

*Phone Number:

*Address:

*City

*Zip

*Email Address:

Can you be dependable and on time?
Yes No

Can you be a team player?
Yes No

Can you have a good attitude and share a smile?
Yes No

Can you sit on the floor and engage in pay with the children?
Yes No

Can you lift 50 pounds?
Yes No

Can you be flexible in your position to meet the needs of the children and the center?
Yes No

Do you hold a certification in any of the following areas?
CPR
First Aid
Universal Precautions
Food/Sanitation

Will you be willing to take these classes if you have not already?
Yes No

Are you looking for full or part-time work?
Full Part Time

If looking for part-time work, how many hours:

What age of children do you prefer to work with or have experience working with?


Is there an age that you can NOT work with? Please explain


Do you have a valid Illinois driver’s license to drive a van to transport children?
Yes No

Have you been convicted of any misdemeanor/felony charges that will show up on a criminal back ground check?
Yes No

Do you have children that would be enrolled in our program if you are hired?
Yes No

Can you turn in needed paperwork to complete your file or your child’s file within 30 days? (required by DCFS)
Yes No

Can you take redirection and guidance if you are employed at our school with a positive frame of mind and attitude?
Yes No

Would you be willing to take additional classes to meet accreditation standards that our school holds to increase your wage and possibly a promotion?
Yes No

What is your highest level of education completed?


Please note what you received your degree in.


Where was your degree earned (e.g. SIU)


How many classes have been completed in early Childhood Education?


Please email school transcripts to moore42601@gmail.com or fax to 618-996-2515

Why do you want to work in an early childhood environment?


Can you give our school a one year commitment if hired?
Yes No

What are you looking for in an employment opportunity with Robin's Nest?


By submitting this application, I agree that I can meet the above standards outlined above that I have answered "Yes" to an have noted any limitations that I have on this employment application form.