7/21/2019 CADC Employment App

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Cornerstone Academy Day Center2720 Arlington Drive

Alexandria, Va 22306

(703) 768-9355 (703) 768-9355  fax

email:cornerstoneacademy2@gmail.com

Employment Application

Personal Inor!ation

 Name: ____________________________ Phone: ____________________ 

Address: ______________________________________________________ 

SSN: _____________________________________ Date of Birth: ___________ 

Position applied for: ________________________ Salary Req. _____________ 

Availability _______________________ Date yo can start: _____________ 

Do yo have any health problems that may interfere !ith flfillin" the #ob responsibilities

$es _____No_____ if yes please e%plain ____________________________________________________________ 

Do yo have children& No _____$es _____ !hat are their a"es& ______________ 

"d#$ation

'i"hest "rade completed _________ 'i"h school diploma ____ yes ____ no ____ (ED

)olle"e& $es ___ no_____ )orses____________________________________ 

"x%erien$e

Place of employment: ______________________ Dates: __________________ 

Phone nmber: ____________________________ Position: __________________ 

Person to contact: __________________ Reason for leavin": _____________________ 

Place of employment: ______________________ Dates: __________________ 

Phone nmber: ____________________________ Position: __________________ 

Person to contact: __________________ Reason for leavin": _____________________ 

&eeren$e'

 Name: ____________________________ Phone: _________________________ 

Relationship: ________________________'o! lon": ________________ 

 Name: _____________________________ Phone: _________________________ 

7/21/2019 CADC Employment App

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Relationship: ________________________'o! lon": ________________ 

Pastoral Reference:

)hrch )rrently Attendin"______________________Phone Nmber_____________ 

Pastor*s Name___________________________________________________________  If you are hired for a position with our company, a pastoral letter is required 

Do yo have e%perience !or+in" !ith children& $es_____ No ______ ,f yes please ans!er the follo!in" qestions.

-en"th of e%perience: _________hat a"e "rops: __________ 

/ob responsibilities: ___________________________________________________.

0rainin" yo have received in the childcare field: ______________________________ 

 ____________________________________________________________________.

'ave yo ever been char"ed1convicted of a felony or misdemeanor related to abse2

ne"lect2 or e%ploitation of children or adlts& $es ______ No ______ 

Are yo !illin" to e%cept trainin" and spervision& $es ______ No_____ 

3no!in" that this center stresses a )hristian -earnin" 4 Nrtrin" atmosphere2 e%plain!hy yo !ish to !or+ here and !hat can yo offer&

 _______________________________________________________________________ 

 _______________________________________________________________________.

Please e%plain yor philosophy on discipline& __________________________________ 

 _______________________________________________________________________.

, nderstand that monthly teacher*s meetin"s are mandatory and 56 hors of in7servicetrainin" is reqired per year.

Emer"ency )ontact: Name:______________________________Phone:_____________ 

Relationship:_____________Address:_________________________________________ 

I ave re$eived read te *ta +andoo and $o!%l. /it te $ontent

 ____________________________ ________________________ Si"natre Date

,ntervie! qestions: _____________________________________________________ 

 ____________________________________________________________________.

Start Date: ________________________ End of employment date: _____________