Application - Phoenix Montessori Academy

Phoenix Montessori Academy
8010 McIlwaine Road
Huntersville, NC 28078

Personal Information

Name *

Address *

Address 1
Address 2

City

State

Zip

Phone Number *

Email Address *

Date of Birth *

Social Security Number

Position Applying For *

United States Citizen? *

Yes No

Salary Requirement *

Number of Hours Required *

Education (You may submit a current resume and refer to it in this application.)

Highest Grade Completed? *

High School Diploma? *

Yes No

College/University

Location

Major

Certificate/Degree

Date

Montessori Certificate

Training Center Location

Date

List any courses in Development/Care of Children and number of Credits Earned (or submit transcript)

Previous Employment

List current or most recent employment first. Feel free to submit your resume listing your full employment history.

Employer #1

Supervisor

Address

Address 1
Address 2

City

State

Zip

Phone Number

Position

Dates of Employment

Duties Performed

Reason for Leaving

May we contact this employer?

Yes No

Contact Name

Contact Phone Number

Employer #2

Supervisor

Address

Address 1
Address 2

City

State

Zip

Phone Number

Position

Dates of Employment

Duties Performed

Reason for Leaving

May we contact this employer?

Yes No

Contact Name

Contact Number

References

Business/professional other than former supervisors)

Name

Relationship

Phone Number

Best Time to Contact

Daytime Evening

Name

Relationship

Phone Number

Best Time to Contact

Daytime Evening

Name

Relationship

Phone Number

Best Time to Contact

Daytime Evening

Have you ever been accused of any form of child abuse? *

Yes No

If yes, explain:

Have you ever been convicted of a crime (other than minor traffic offenses)? *

Yes No

If yes, explain:

Is there anything that prevents you from performing the essential functions of this job with or without reasonable accommodations?

Briefly explain why you want to work for Phoenix Montessori Academy:

Describe any additional experience relating to education or group care of children (e.g. volunteer work, internships, Montessori experience, etc.):

Do you have current first aid training? *

Yes No

Date of Training

Do you have current CPR training? *

Yes (Adult Only) Yes (Pediatric Only) Yes (Both) No

Date

By submitting this application, I certify that all answers and statements on this application are true. I have completely set forth my qualifications and experience and I waive the right to present any additional facts at any time in the future during my employment in the event of any review or classification appeal of my employment. I understand that should an investigation disclose willful falsification, my application may be rejected, my name removed from consideration, or if I am employed by the school, the falsification shall be considered sufficient cause for termination. You are hereby authorized to make an investigation of my record with no liability therefore.

Full Name (constitutes your signature and agreement) *

Date *

Resume or Transcript (pdf only)

(allowed file types: pdf)

Phoenix Montessori Academy fully embraces diversity as a core value. The school does not discriminate against employees, applicants or students on the basis of race, religion, national or ethnic origin in its hiring practices or administration of its educational and admissions policies or any school-administered program.

Enter Your Email Address: *