We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital status, veteran status, sexual orientation, or any other legally protected status. Step 1 of 2 50% Position(s) Applied For* Date of Application* MM slash DD slash YYYY How Did You Learn About Us?* Advertisement Friend Walk-In Employment Agency Relative Other Name* First Middle Last Email* Address Street Address Address Line 2 City State ZIP / Postal Code Telephone Number* Are you over 18 years of age, or, if you are under 18, can you provide required proof of your eligibility to work?* Yes No Have you ever filed an application with us before?* Yes No If Yes, give date* MM slash DD slash YYYY Have you ever been employed with us before?* Yes No If Yes, give date* MM slash DD slash YYYY Are you currently employed?* Yes No May we contact your present employer?* Yes No Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?* Yes No On what date would you be available for work? MM slash DD slash YYYY Are you available to work:* Full Time Part Time Shift Work Temporary Are you currently on “lay-off” status and subject to recall?* Yes No SproutCare Solutions requires travel to various Central Ohio schools. Do you have reliable transportation?* Yes No SproutCare Solutions provides substitute teachers for various Central Ohio Schools. Are you willing to work for private, religious based, Montessori, corporate and/or family owned schools?* Yes No If no, please explainHave you been convicted of a felony within the last 7 years?* Yes No Conviction will not necessarily disqualify an applicant from employment.If yes, please explainEducationElementary School Name and Address Course of Study Years Completed Diploma Degree High School Name and Address Course of Study Years Completed Diploma Degree Course of Study Years Completed Diploma Degree Graduate Professional School Name and Address Course of Study Years Completed Diploma Degree Other (Specify) Course of Study Years Completed Diploma Degree Language ProficiencyIndicate any foreign languages you can speak, read and/or writeLanguage 1 Name WriteSelect ProficiencyFluentGoodFairSpeakSelect ProficiencyFluentGoodFairLanguage 2 Name ReadSelect ProficiencyFluentGoodFairWriteSelect ProficiencyFluentGoodFairSpeakSelect ProficiencyFluentGoodFairLanguage 3 Name ReadSelect ProficiencyFluentGoodFairWriteSelect ProficiencyFluentGoodFairSpeakSelect ProficiencyFluentGoodFairDescribe any specialized training, apprenticeship, skills and extra-curricular activities.EMPLOYMENT EXPERIENCEStart with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, creed, gender, national origin, age, disability, marital status, veteran status, sexual orientation, or any other legally protected status.Employer Address Street Address Address Line 2 City State ZIP / Postal Code TelephoneJob TitleSupervisorReason for LeavingDates EmployedFrom MM slash DD slash YYYY To MM slash DD slash YYYY Hourly Rate/SalaryStarting Final Work PerformedEmployer Address Street Address Address Line 2 City State ZIP / Postal Code TelephoneJob TitleSupervisorReason for LeavingDates EmployedFrom MM slash DD slash YYYY To MM slash DD slash YYYY Hourly Rate/SalaryStarting Final Work PerformedPlease disclose any prior employment terminations or other disciplinary action you have received for threats of violence.ADDITIONAL INFORMATIONOther QualificationsSummarize special job-related skills and qualifications acquired from employment or other experienceState any additional information you feel may be helpful to us in considering your application.Note to Applicants:DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A description of the activities involved in such a job or occupation is attached. Yes No Reference Info:Name First Last PhoneAddress Street Address Address Line 2 City State ZIP / Postal Code Reference Info:Name First Last PhoneAddress Street Address Address Line 2 City State ZIP / Postal Code Reference Info:Name First Last PhoneAddress Street Address Address Line 2 City State ZIP / Postal Code APPLICANT’S STATEMENTI certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. I hereby understand that this position is subject to the requirements of either state or federal (DOT) and drug testing rules that the Company may condition any offer of employment upon the successful passing of a drug and alcohol test.Total of 2 + seven =* CAPTCHA
