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Job Application

Job Application

Please fill in as much information as possible to apply for a career at Early Childhood Alliance. Items marked with an * are required.

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I am applying for...*
If applying for a position other than teacher, select Other then entre the desired position.
- A Teacher Position
Personal Information
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
How many years have you been at your current place of residence*
Phone Number*
Email*
The last four (4) digits of your Social Security Number (SSN)*
Your birth month and day*

Please do not include your year of birth, just month and day.

General Information
Have you ever applied for employment with us?*
- Yes
- No
If Yes, when?*
MM slash DD slash YYYY
Desired Pay/Compensation*
Please provide a range.
I am looking to work...*
- Full-Time
- Part-Time
What days of the week are you willing to work?*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Check all that apply.
I would like to work from*

Enter your desired, daily start time.
I would like to work till*

Enter your desired, daily end time.
If asked, will you work over-time?*
- Yes
- No
When will you be able to begin work?*
MM slash DD slash YYYY
Are you a U.S. citizen or alien authorized to work in this country?*
- Yes
- No
Are you 18 years of age or older?*
- Yes
- No

Employment History
Please enter employment information for Company 1
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Company Phone
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Title
Description
Hourly Pay
Reason for leaving
Is it okay if we contact this employer?
- Yes
- No
If no, please explain
Please enter employment information for Company 2
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Company Phone
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Title
Description
Hourly Pay
Reason for leaving
Is it okay if we contact this employer?
- Yes
- No
If no, please explain
Please enter employment information for Company 3
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Company Phone
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Title
Description
Hourly Pay
Reason for leaving
Is it okay if we contact this employer?
- Yes
- No
If no, please explain
Please enter employment information for Company 4
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Company Phone
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Title
Description
Hourly Pay
Reason for leaving
Is it okay if we contact this employer?
- Yes
- No
If no, please explain

Education
College Information
My current education includes...*
- High School Diploma or GED
- Associate's Degree
- Bachelor's Degree
- Master's Degree
- CDA
- Some college credits
College Name*
Location*
Years Completed*
Please enter numbers only
Major*
High School Information
High School Name
Location
Years Completed
Please enter numbers only
Diploma
Other Training
Provide information regarding other training you have achieved

Military Record
Branch of Service
Active From
MM slash DD slash YYYY
Active To
MM slash DD slash YYYY
Discharge Date
MM slash DD slash YYYY
Duties
Training
Physical Limitations
Are there any tasks that you cannot perform due to physical limitations?*
- Yes
- No
If Yes, please explain*
Miscellaneous
Professional or Civic Organization Memberships
Please exclude those that may disclose race, religion, or national origin.
Where did you find out about this job?*
I was referred to Early Childhood Alliance by...

Enter the name of the person who referred you to our organization so we may thank them.
If Other, please describe*

Attachments
Attach your resume, cover letter, and/or references here
Drop files here or

Max. file size: 50 MB, Max. files: 5.
Agreements
I will provide personal references upon request.*
- I agree
I hereby declare that the information provided by me in this application to be true, correct, and complete to the best of my knowledge. I understand that if employed, any misstatement or omission of fact on this application shall be considered cause for dismissal.*
- I agree
I have and understand the privacy policy.*
- Yes
Name
This field is for validation purposes and should be left unchanged.

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Early Childhood Alliance
3800 N Anthony Blvd, Fort Wayne, IN 46805
(260) 745-2501 | Food Program: (260) 333-8290 | Fax: (260) 744-3473 | (800) 423-1498 | Emergency Hotline: (260) 579-4443
Office Hours: Mon-Thurs - 7:30am-5:30pm | Fri - 7:30am-11:30am

© Early Childhood Alliance

Early Childhood Alliance is a registered 501c3 non-profit organization, FID: 35-0953465.

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Call Local: 260-745-2501
Call Toll Free: 800-423-1498
Admin Offices: 3800 N Anthony Blvd, Fort Wayne, IN 46805
Beacon Learning Center: 2125 Beacon St, Fort Wayne, IN 46805
Downtown Learning Center: 516 E Wayne St, Fort Wayne, IN 46802
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