YOUR NAME

SOCIAL SECURITY NUMBER

HOME ADDRESS:

HOME PHONE

MOBILE PHONE

Your Email

ARE YOU AT LEAST 18 YEARS OLD:

Indicate the shifts you are available to work by placing a check by the appropriate shift:

Are there any restrictions when you can work, i.e. School, child care, another job etc: if yes please explain:

HAVE YOU EVER BEEN ARRESTED OR CONVICTED OF A CRIME: An arrest or conviction does not disqualify you from employment with BoomKidz. List all arrests convictions:

HOW DID YOU HEAR ABOUT THIS JOB:

HAVE YOU EVER BEEN FIRED FROM A JOB: if yes please explain:

MAY WE CONTACT ALL OF YOUR PREVIOUS EMPLOYERS: if NO please explain:

DID YOU GRADUATE HIGH SCHOOL OR GET AN EQUIVALENCY DIPLOMA:

HIGHEST YEAR OF HIGH SCHOOL COMPLETED:

HIGH SCHOOL ATTENDED:

FULL ADDRESS:

COLLEGE DEGREE OR HIGHEST YEAR COMPLETED:

COLLEGE

OTHER EDUCATION:

NAME AND TYPE OF SCHOOL:


List your most recent employment first. Indicate all employment whether full or part time. List at least five years. Do not leave any gaps list all periods of unemployment. If more space is required additional forms are available.

NAME of COMPANY:

ADDRESS of COMPANY:

DATES of EMPLOYMENT:

FROM:

TO:

SUPERVISOR:

PHONE:

POSITION:

DUTIES:

REASON FOR LEAVING:


NAME of COMPANY:

ADDRESS of COMPANY:

DATES of EMPLOYMENT:

FROM:

TO:

SUPERVISOR:

PHONE:

POSITION:

DUTIES:

REASON FOR LEAVING:


NAME of COMPANY:

ADDRESS of COMPANY:

DATES of EMPLOYMENT:

FROM:

TO:

SUPERVISOR:

PHONE:

POSITION:

DUTIES:

REASON FOR LEAVING:


REFERENCES: List three personal references (Not Relatives) you have known for at least two years.

NAME:

HOW LONG KNOWN:

ADRESSS:

TELEPHONE #:


NAME:

HOW LONG KNOWN:

ADRESSS:

TELEPHONE #:


NAME:

HOW LONG KNOWN:

ADRESSS:

TELEPHONE #:


I understand that as a condition of employment, I may be required to submit to the tests below:

Drug Test:


BoomKidz Inc. is an equal opportunity employer. The treatment of all employees and applicants for employment with BoomKidz Inc. is without unlawful discrimination to race, creed, color, national origin, sex, age, disability, citizenship status, handicap, marital status, sexual orientation of affectional preference in all employment decisions, including but not limited to, recruitment, promotion, upgrading, demotion, downgrading, transfer, layoff and termination and all other conditions of employment except as provided by law.

I voluntarily give BoomKidz permission to accomplish a complete investigation of my past employment and activities with the exception of where I have indicated differently. I agree to cooperate with such an investigation and release from all liability and responsibility all persons and companies supplying information on my past activities.

I hereby agree to release BoomKidz Inc. from any liability and or claims that I may have arising from or related to any background investigation or testing including psychological or drug tests.

I certify that all information given on this application true and correct. I understand that any false statements or misrepresentations are grounds for immediate dismissal.

APPLICANTS DIGITAL SIGNATURE:

DATE:


DO YOU HAVE ANY EXPERIENCE ENTERTAINING KIDS IN THE FOLLOWING?

GAMES:

Freeze DanceMusical ChairsHot PotatoPin the Tail on the DonkeySimon SaysBirthday BingoDuck, Duck GooseRed Light/Green LightHop Scotch GameHokey PokeyLimboParachute


DANCEMAGICART AND CRAFT

ANY OTHER NOT LISTED: