Name

First Name

Last Name

Social Security Number

Address

City

State

Zip

Email Address

Phone Number

Position(s) Desired

Administrator

Lead Teacher

Assistant Teacher

Support Staff

Salary Range Expected

Are you vaccinated for Covid-19?

Yes

Educational Background

Undergraduate Degree Preferred

College/University

Location

Major

Certificate/Degree

Date of Graduation

Montessori Certificate

Date

Location

Additional Education and Degrees

Previous Employment

List current or most recent employment first.

Employer

Supervisor

Address

Telephone

Position

Salary

Duties

Reason for leaving

Start Date

YYYY

End Date

YYYY

May we contact this employer?

Yes

If yes, who should we contact?

Employer

Supervisor

Address

Telephone

Position

Salary

Duties

Reason for leaving

Start Date

YYYY

End Date

YYYY

May we contact this employer?

Yes

Employer

Supervisor

Address

Telephone

Position

Salary

Duties

Reason for leaving

Start Date

YYYY

End Date

YYYY

May we contact this employer?

Yes

Employee Related References

Name

Occupation

Address

Telephone

Name

Occupation

Address

Telephone

Name

Occupation

Address

Telephone

Affirmation

I hereby 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 dismissal and termination. You are hereby authorized to make an investigation of my record of any or all of my former employers, with no liability therefore.

Please affirm this statement by signing your name below as / First Name Last Name /

Signature

Date

YYYY

It is our policy to hire and promote without regard to race, creed, color, sex or national origin, or mental or physical handicap unrelated to job performance.

Thank you for your application! We will reach out if we have an open position that might be an appropriate match.

EMPLOYMENT Application