Application

  1. Full Name

  2. Address

  3. City

  4. State

  5. Zip

  6. Phone Number

  7. Email


  8. Position Applying For

  9.  

    Full TimePart Time


  10. Days & Time Available

  11. Salary Expected

  12. Do you have reliable transportation?
    YesNo

  13. Are you interested in bringing your children to work with you?
    YesNo

  14. Ages


  15. Do you have any physical condition that may restrict your performance of the job you are applying for?
    YesNo

  16. (Explain)


  17. Will you need any time off in the next 90 days?
    YesNo

  18. (Explain)


  19. Have you ever been convicted of a crime?
    YesNo

  20. Please be prepared to show documentation of all information you list below

    Education

  21. High-School

  22. DateCompleted


    (GED or highest grade completed if not diploma)


  23. College:

    Date Completed
  24. Major:

    Degree/Certificate


  25. Number of credit hours in early childhood development

  26. Other licenses, credentials or certificates that may qualify you

  27. Do you have an active First-Aid & CPR certification?
    YesNo

  28. ExpirationDate:First-Aid

    CPR


  29. Are you certified in Medication Administration Training (MAT)?
    YesNo

  30. Please list only child-related work experience in this section


  31. Business Name

  32. Phone #


    Job Title

    Age Cared For?


    Salary


    Reason For Leaving


    Supervisor's Name


    Dates Employed

    to


  33. Business name

  34. Phone #


    Job title


    Age Cared For?


    Salary


    Reason For Leaving


    Supervisor's Name


    Dates Employed

    to


    Non Child Care Work

  35. Business Name

  36. Phone #


    Job Title


    Salary


    Reason For Leaving


    Supervisor's Name


    Dates Employed

    to


  37. Volunteer Or Unpaid Experience


  38. Have you ever been employed at Kimbi's before?
    YesNo

  39. Dates Employed

    to


  40. What qualities about you will benefit Kimbi's?

  41. References: Two Professional references are required (Please list supervisors only, not co-workers)

  42. Employer Name

  43. Title


    Phone #


  44. Employer Name

  45. Title


    Phone #

    Persons to be notified in case of illness or emergency)

  46. Name
  47. Address

    Relationship


    Phone#
    Name


    Address

    Relationship


    Phone#

    By clicking the SUBMIT button, the applicant acknowledges all information provided to be accurate and truthful. The applicant also understands that if the information provided is found to be otherwise, the applicant shall be disqualified from consideration and or terminated from employment.

    Please be sure your application is complete prior to clicking the Submit button.