Doodle Bugs! Employment Application For Maintenance Positions Only

It is the policy of Doodle Bugs! to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status.

Please complete every section of this application. Incomplete applications will not be reviewed.

Applicant First Name*  
  Last Name*  
  Last Four Digits of Social Security Number*  
  Email Address*  
Present Address Address*  
  City*  
  State*  
  Zip*  
  Telephone*  
Permanent Address
(if different)		 Address  
  City  
  State  
  Zip  
  Telephone  
Employment Eligibility Are you legally employable within the United States at the present time?*   Yes
 No
In accordance with New York OCFS Law, each applicant is required to complete a criminal conviction statement upon hiring. Persons convicted of certain criminal offenses may be barred from employment in a child care environment. Answering YES may not necessarily disqualify an applicant from employment. Have you ever been convicted of a crime?*   Yes
 No
  If you answered yes to the above question, please describe details of crime.  
General Questions Have you ever applied here before?*   Yes
 No
  If you answered yes to the above question, please indicate last application date.  
  Were you ever employed by Doodle Bugs! in the past?*   Yes
 No
  If you answered yes to the above question, please indicate which center and time period.  
  How were you referred here?*  
  If referred by friend/employee, please provide their name:  
Desired Employment Position Applying For*  
  If the above position is not available, would you consider another position? If so, please list.  
  Employment Type*  
  Salary Desired*  
  Location Desired*  
  Date Available To Start*  
  Please indicate the days and times which you are available to work*:  
Previous Employers
     Starting With Current or Most Recent		 Dates Employed  
  Company Name  
  Address  
  Telephone  
  Supervisor  
  May we contact your Supervisor?   Yes
 No
  Duties  
  Beginning Salary  
  Ending Salary  
  Reason For Leaving  
     Other Employer Dates Employed  
  Company Name  
  Address  
  Telephone  
  Supervisor  
  May we contact your Supervisor?   Yes
 No
  Duties  
  Beginning Salary  
  Ending Salary  
  Reason For Leaving  
     Other Employer Dates Employed  
  Company Name  
  Address  
  Telephone  
  Supervisor  
  May we contact your Supervisor?   Yes
 No
  Duties  
  Beginning Salary  
  Ending Salary  
  Reason For Leaving  
Previous Unemployment
     Starting With Most Recent Period		 Date Unemployment Began  
  Date Unemployment Ended  
  Reason for Unemployment  
     Other Period Date Unemployment Began  
  Date Unemployment Ended  
  Reason for Unemployment  
  Are you currently on "layoff status" and subject to recall?*   Yes
 No
Education Background High School*  
  Did you Graduate?*  
  Major, if any  
  College/University/Technical School  
  Address  
  Did you graduate?  
  If still in college, which courses are you presently taking?  
  College Major, if any  
  College Minor, if any  
  Professional Licensure/Certifications  
  Special Skills (example - floor buffing)  
References (Please list 3) Name*  
  Address*  
  Telephone*  
     Second Reference Name*  
  Address*  
  Telephone*  
     Third Reference Name*  
  Address*  
  Telephone*  
About You
On a scale of 1 to 10, please indicate
the level which best describes you.		 Are you conscious of your strengths and weaknesses?*  
Never              Sometimes             Always Are you confident?*  
1     2     3     4     5     6     7     8     9     10 Do you have a sense of humor when things go wrong?*  
  Are you flexible in the workplace?*  
  Are you organized?*  
  Do you take responsibility for your own actions?*  
  Do you enjoy working with a team to get the job done?*  
  Do you maintain honesty & integrity in your life?*  
  Do you take initiative in your life?*  
Never              Sometimes             Always Do you communicate effectively?*  
1     2     3     4     5     6     7     8     9     10 Can you problem solve without reacting emotionally?*  
  Do you remain positive in a negative situation?*  
  Do you guide & inspire others in the workplace?*  
  Are you creative?*  
  Are you dependable?*  
  Any additional comments?  

Certification of This Application
 By submitting this Application, I certify that the information provided on this Application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my Application, or if employment commences, immediate termination.

I authorize Doodle Bugs! to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades.  I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created, the employment relationship will be entirely voluntary in nature. In other words, with appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer would have the same right.  Moreover, no agent, representative, or employee of Doodle Bugs!, except in a specific written contract of employment signed on behalf of the organization by its President has the power to alter or vary the voluntary nature of the employment relationship.