Early Childhood Education Application

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* 1. Fill us in on the basics!

Name

Birthdate

Address

Phone Number

Facebook profile name

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* 2. Please list the schools you have attended

High School

Grade completed in high school

College

Years completed

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* 3. Tell us about your work experience

Place of employment and length of time there

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* 4. Do you have any experience with Early Childhood Education skills?

Yes, I've worked in the industry

Yes, all the time at home

Have done a little, but nothing professional

I have no idea what I'm doing, but interests me!

Other (please specify)

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* 5. What would be your first choice of a job?

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* 6. What would be your second choice of a job?

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* 7. What would be your third choice of a job?

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* 8. Are you ready to work in the Early Childhood Education field once you complete these classes?

Yes, absolutely

Yes, if I can find childcare

Not really sure I want a job at this point

I'm just doing this for fun and don't plan on doing anything permanent with the training

Other (please specify)

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* 9. This class will be held on Monday's from 6:30pm-8:30pm. Does this work for your schedule?

Yes

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* 10. Are you willing to make these classes and opportunities a priority and attend all twelve weeks? Six weeks will be in the classroom and then the next six weeks you will run our childcare like a daycare.

Yes, I'm all in

Not sure I can commit

I have a job that may interfere

Other (please specify)

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* 11. Part of the JOBS programming involves working with a mentor and working with the Financial Empowerment Center on budgeting your finances. Are you good with these things?

Love the idea of both, can't wait!

A mentor sounds great, but I don't want to work on my money

Not sure I want a mentor

I don't really want a mentor or to work on my finances

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* 12. If you have a child/children please list their names and ages.

Child 1

Child 2

Child 3

Child 4

Child 5

Child 6

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* 13. Will you need help with childcare to take this class?

Yes

Early Childhood Education Application

Question Title

* 1. Fill us in on the basics!

Question Title

* 2. Please list the schools you have attended

Question Title

* 3. Tell us about your work experience

Question Title

* 4. Do you have any experience with Early Childhood Education skills?

Question Title

* 5. What would be your first choice of a job?

Question Title

* 6. What would be your second choice of a job?

Question Title

* 7. What would be your third choice of a job?

Question Title

* 8. Are you ready to work in the Early Childhood Education field once you complete these classes?

Question Title

* 9. This class will be held on Monday's from 6:30pm-8:30pm. Does this work for your schedule?

Question Title

* 10. Are you willing to make these classes and opportunities a priority and attend all twelve weeks? Six weeks will be in the classroom and then the next six weeks you will run our childcare like a daycare.

Question Title

* 11. Part of the JOBS programming involves working with a mentor and working with the Financial Empowerment Center on budgeting your finances. Are you good with these things?

Question Title

* 12. If you have a child/children please list their names and ages.

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* 13. Will you need help with childcare to take this class?

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* 14. Did an agency or organization refer you? If yes, list who. If no, list how you heard about JOBS.

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* 15. Do you have a Driver's License?

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* 16. Do you have a vehicle?