Application for Employment

NAME:*
First Last
ADDRESS:*
Street Address City State / Province / Region ZIP / Postal Code
PHONE:*
Position applied for*
Location*
Do you have a high school diploma or its equivalent?
Date available for work:*
Will you work overtime if required?*
Will you undergo a pre-employment physical, background check and drug screening?*
- Yes
- No
Have you been charged or convicted of a felony in the past seven (7) years?*
- Yes
- No
If yes, please explain (a charge or conviction may be relevant if job-related):
May we contact your previous employer?*
- Yes
- No
Work Number:
Have you filed an application or worked here before?*
- Yes
- No
Previous Work (Start)
Previous Work (End)
Are you legally eligible for employment in this country?*

(Proof of citizenship or legal immigration work status may be required upon employment)
Have you ever been bonded?*
- Yes
- No
Type of employment desired:*
- Full Time
- Part Time
- Temporary
- Seasonal
Are you on a lay-off and subject to recall?*
- Yes
- No
Will you relocate if job requires?*
- Yes
- No
Will you travel if job requires?*
- Yes
- No
Employer 1:
Phone:
Address:
Job Title:
Supervisor:
Reason for Leaving:
May we contact as a reference?
- Yes
- No
Date Employed (Start)
Date Employed (End)
Nature of the work performed and responsibilities:
Employer 2:
Phone:
Address:
Job Title:
Supervisor:
Reason for Leaving:
May we contact as a reference?
- Yes
- No
Date Employed (Start)
Date Employed (End)
School 1:
Number of Years Completed:
Degree or Diploma:
School 2:
Number of Years Completed:
Degree or Diploma:
School 3:
Number of Years Completed:
Degree or Diploma:
Reference 1 Name:
Phone:
Reference 2 Name:
Phone:
Reference 3 Name:
Phone:
SKILLS AND QUALIFICATIONS*
Summarize any special skills and qualifications you feel may qualify you for work with our company:
List any further information you would like us to consider:*
Referral source?*
- Advertisement
- Employee
- Relative
- Walk-in
- Government Employment Agency
- Private Employment Agency
- Other

Youthland Academy has 18 day care centers in the Cincinnati and Dayton, Ohio & northern Kentucky areas. Locate the closest one to you here. Our staff is more than willing to answer any questions you have about our programs and curricula and how else we can help enrich your child’s life.

Email: info@youthlandacademy.com
MyYouthland

Youthland Academy, Inc. is an equal opportunity provider and employer.
© 2021 Youthland Academy, Buddy Bear, Inc. Each location independently owned and operated.

Application for Employment

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