Yes No

Additional addresses where you have resided at any time during the past two years:

Optional Information:


Full Time Part Time   
InfantsToddlers Preschool School Age (5-10)


Church/Community Involvement

List activities, leadership positions, volunteer work, etc. that you participate in on a regular basis.


Are you comfortable with reading bible stories to students and praying with students?Yes No


SchoolName & Location of SchoolDates Attended# of yearsDate of GraduationDegree / Diploma
Graduate School
High School
Early Education Classes

Licenses and Certificates (CPR/1st Aid, Fingerprint card, Food Handlers, ECE Classes/Training)

LicenseLicense Number & StateExpiration Date

EMPLOYMENT(Provide accurate, complete employment record. Start with present or most recent employer)

Employer NameTelephoneEmployed Dates
Name of SupervisorReason for Leaving

Employer NameTelephoneEmployed Dates
Name of SupervisorReason for Leaving

Employer NameTelephoneEmployed Dates
Name of SupervisorReason for Leaving
PermissionAdministration may contact the employers listed above unless indicated below.
1. Employer Name Reason
References1. Professional Reference Phone 2. Recent Supervisor Phone
SignatureI verify that I have read this application and declare that my answers are true and complete.
Printed Name DateSignature


This application is to be completed by all applicants for any position (volunteer or compensated) at Sahuaro Preschool. It is used to help provide a safe and secure environment for those children and youth who participate in our programs and our facilities.

  1. YesNo If yes, please explain
  2. YesNo

    If yes, please explain

  3. YesNo

    If yes, describe all convictions in the past five years

  4. YesNo

    If yes, describe all occurrences in the past five years

  5. YesNo

    If yes, please explain detail. Use a separate sheet of paper if necessary

Signature I acknowledge that the answers to the above statements are true and complete. If necessary, I authorize Sahuaro Preschool to further investigate references, work records, evaluations, education or any other matters related to my suitability for employment. Furthermore, I authorize any references or former employers to disclose to the school any and all employment records, performance reviews, letter, reports and other information related to my life and employment, without giving me prior notice of such disclosure. In addition, I hereby release Sahuaro Preschool, my former employers, references and all other parties from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure. I waive the right to personally view any references given to Sahuaro Preschool.


  1. Why would you like to have this position?
  2. What do you feel qualifies you for this position?
  3. What qualities would you bring to Whiz Kidz in addition to your experience and education?
  4. What is the difference between directing child’s play and facilitating a child’s play?
  5. How would you communicate to a parent if their child had a difficult day?
  6. Give an example of a typical daily schedule for a classroom of your choice (infant-school age)