Apple Ridge Academy Employment Application Applicant Information Question Title * Contact Information (Required.) Name Address City/Town State -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * Have you spoken with or been contacted by an administrator at Apple Ridge Academy already? Please indicate who you have been in touch with. (Required.) No, I have not been in contact yet. Carolyn Bell Tammy Imme Ashley French Meghan Alfors Question Title * Are you a US citizen? (Required.) Yes No Question Title * How did you find our company and/or job posting? (Required.) Internet Job Posting Current or Past Employee (please list name in comments) Current or Past Family/Customer (please list name in comments) Job Fair or Community Event Other or Comments Question Title * Position Applying For (Select All Positions of Interest): Open to Any Lead Teacher Assistant Teacher Floater Teacher Infant Teacher Toddler Teacher Twos Teacher Jr. Preschool Teacher Preschool Teacher PreK Teacher 4K Teacher Afternoon Closing Teacher Summer School Age Teacher Kitchen Cook Comments: Question Title * Which location are you applying for a position at? (Required.) Brookfield/Pewaukee New Berlin Open to Either Location Question Title * Hourly Wage Desired (Required.) Question Title * Employment Desired (Required.) Part-Time Full-Time Open to Either # of hours desired Question Title * Availability (Required.) Open Availability Limited Availability (please explain) Question Title * Are you over 18 years old? (Required.) Yes No Question Title * Date Available to Begin Work (Required.) Date / Time Date Question Title * Are you able to perform the essential functions of the position you are applying for? (Note: We comply with the Americans with Disabilities Act and consider reasonable accommodation measures that may be necessary for eligible applicants to perform essential functions.) (Required.) Yes No Education Question Title * Qualifications / Education Completed (Required.) High School Some College Associate Degree Bachelors Degree Early Childhood 1 (Introduction to the Childcare Profession / Assistant Teacher Qualification) Early Childhood 2 (Skills & Strategies / Lead Teacher Qualification) Infant/Toddler Certificate CPR Mandated Reporter Training Shaken Baby Syndrome / Abusive Head Trauma Other (please specify) Question Title * Are you currently on The Wisconsin Registry? (Required.) No Yes. I am a level... Question Title * College Information School Name School Location # of Years Completed Degree(s) Earned Major Field(s) of Study Question Title * College #2 Information (if applicable) School Name School Location # of Years Completed Degree(s) Earned Major Field(s) of Study Question Title * Please list and explain any other training/education you have related to Early Childhood Education Employment History Please begin with your most current or most recent employer and list all positions held within the past 7 years. Also indicate any other experience which you believe is relevant to the position for which you are applying (i.e. volunteer, military service, internships, etc.) Question Title * Employer #1 (Required.) Employer Name Address Phone Your Job Title Supervisor's Name Salary/ Hourly Wage Dates of Employment (start/end) Reason for Leaving (or reason for seeking a new opportunity) Question Title * Employer #2 (Required.) Employer Name Address Phone Your Job Title Supervisor's Name Salary/ Hourly Wage Dates of Employment (start/end) Reason for Leaving (or reason for seeking a new opportunity) Question Title * Employer #3 (Required.) Employer Name Address Phone Your Job Title Supervisor's Name Salary/ Hourly Wage Dates of Employment (start/end) Reason for Leaving (or reason for seeking a new opportunity) Question Title * Other relevant experiences. Please provide as many details as possible including names, location, dates, etc. Question Title * Periods of Unemployment Dates Reason Dates Reason Dates Reason Professional References Please list at least 3 references, other than relatives, who could speak about your professional experiences. Question Title * Reference #1 (Required.) Name Position Company Address Phone Question Title * Reference #2 (Required.) Name Position Company Address Phone Question Title * Reference #3 Name Position Company Address Phone Question Title * Reference #4 Name Position Company Address Phone Comments Question Title * Please share with us any additional information about yourself that you would like us to take into consideration when reviewing your application. Resume Question Title * Please attach a copy of your resume. Applicant's Statement Question Title * By checking each box you are agreeing to the statements below. (Required.) The information that I have provided on this application is accurate to the best of my knowledge and may be verified by Apple Ridge Academy representatives. I authorize all the schools, persons and organizations named in this application to provide any relevant information in their possession or knowledge to the agents of Apple Ridge Academy, for use in deciding whether or not to offer me employment and specifically waive any required written notifications. I hereby release my former employers, Apple Ridge Academy and all other persons from any and all claims, demands or liabilities arising out of or in any way related to such inquiry. I understand that Apple Ridge Academy is committed to maintaining a drug and alcohol free work place. I understand that if employed, I may be subject to a drug and alcohol screening if the Director of Apple Ridge Academy has reasonable suspicion to believe that I am under the influence of drugs or alcohol. My consent to submit to such a test is required as a condition of employment and my refusal to consent shall result in a refusal to hire, or if already employed, termination. I understand and agree that any misrepresentation or omission of facts in this application will be justification for refusal or termination of employment, regardless of the time elapsed before discovery I understand and agree that the employment for which I am applying for is at-will, and such employment may be terminated at any time with or without cause, without prior notice, by the management of ARA. I have placed my electronic signature below only after I have completed the entire application to the best of my ability and have careful read the foregoing statements. Electronic Signature Question Title * Please Type Your Name for an Electronic Signature (Required.) Question Title * Today's Date (Required.) Date / Time Date Apple Ridge Academy, LLC is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, age or disability. We assure you that your opportunity for employment with our company depends solely on your qualifications. Thank you for your interest in our organization! Page1 / 1 100% of survey complete. Done