Timeless Play Job Application Timeless Play Job Application Step 1 of 3 - Basic Info 0% Tell us more about yourself.What position are you applying for? Timeless Play Employee/Regular Staff Internship Name First Last Email PhoneAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Are you legally able to work in the US?* Yes No Are you 18 years of age or older?* Yes No Have you ever applied for our agency before?* Yes No Do you have at least 6 months of childcare experience in a licensed center?* Yes No Do you currently have a valid finger-print clearance card?* Yes No Maiden name (if applicable) Do you have access to reliable vehicle?* Yes No Do you have any medical conditions or lifestyle restrictions that would prevent you from being able to perform child care duties? (Lifting limitations, non-swimmer, unable to transport children, etc.)Please list the days and times you are available to work:*Why are you interested in a position through our center?*Tell us more about your last position. Why did the position end or why are you leaving?*How does Timeless Play fit into your short-term and long-term goals?* Your Education & ExperienceHigh School / City* Degree Obtained* Yes No College / Major* Degree Obtained* Yes No Highest Level Degree Obtained & Year Obtained* Please describe your childcare experience (number of years, type, etc.)Select age group(s) you have experience with: Newborn (0-3 months) Infants (3-12 months) Toddlers (1-3 years) Preschool (3-5 years) School-Aged (5-12 years) Teenagers (12+) Your Work History1. Company/Family Supervisor May we contact your supervisor? Yes No PhoneStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Ending Salary Reason for Leaving2. Company/Family Supervisor May we contact you supervisor? Yes No PhoneStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Ending Salary Reason for Leaving Signature & DisclaimerApplication Disclaimer and AcknowledgementI certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire or refer me, or for discharge, should I be hired. I authorize any person, organization, or company listed on this application to furnish Timeless Play (TP) any and all information concerning my previous employment, education, and qualifications for employment. I also authorize TP to request and receive such information. In consideration for any employment with or through the center, I agree to abide by the rules and regulations of the center, which rules may be changed, withdrawn, added or interpreted at any time, at the employer’s sole option and without prior notice to me. I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of the employer or myself. This application initiates the process to be considered for either employment or internship with Timeless Play.Email* PLEASE use the same email address you used on the previous page. Printed Name* Signature*Date* Month Day Year CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.