Premier Academy - Atlanta, GA

Education
High School:
Address
Street Address Address Line 2 City State ZIP Code
From:
To:
Did you graduate?
- Yes
- No
Diploma:
College
Address
Street Address Address Line 2 City State ZIP Code
From:
To:
Did you graduate?
- Yes
- No
Degree
Other
Address
Street Address Address Line 2 City State ZIP Code
From:
To:
Did you graduate?
- Yes
- No
Degree

Save and Continue Later

Child Care Experience
Have you attended/completed any child care training courses?*
- Yes
- No
Name
Date
Name
Date
Name
Date
Have you had CPR training within the past 2 years?*
- Yes
- No
Expiration Date
Have you had First aid training within the past 3 years?*
- Yes
- No
Expiration Date
Department of Human Resources requires annual child care training, are you willing to participate?*
- Yes
- No

Save and Continue Later

Employment History
Company
Phone
Employer Address
Street Address Address Line 2 City State ZIP Code
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From / To
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Company
Phone
Employer Address
Street Address Address Line 2 City State ZIP Code
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From / To
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Company
Phone
Employer Address
Street Address Address Line 2 City State ZIP Code
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From / To
Reason for Leaving
May we contact your previous supervisor for a reference?*
- Yes
- No

Save and Continue Later

Military Service
Branch
From
To
Rank at Discharge
Type of Discharge

Save and Continue Later

Disclaimer and Signature
Have you ever been shown by credible evidence, e.g., a court order of jury, a department investigation or other reliable evidence to have abused, neglected or deprived a child or adult or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct?*
- Yes
- No
If yes, please explain.
Under the American with Disabilities Act of 1991, this program is required to reasonably accommodate individuals with disabilities. The reasonable accommodation requirement applies to the application process, any preemployment testing, interviews and actual employment, but only if the program supervisor is made aware that an accommodation is required. If you are disabled and require accommodations, you may request it at any time during the interview process. You are obligated to inform the program director of your needs if it will impact your ability to perform the job for which you are applying for.
Having read the job description for the position for which you are applying, are you in all respects, able to adequately preform the duties as described?*
- Yes
- No
If no, please explain.
Parent/Guardian Verification
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
SIGNATURE (Parent/Guardian):*
Date*
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Join Our Team

Step 1 of 6 - Applicant Information

Applicant Information

Education

Child Care Experience

Employment History

Military Service

Disclaimer and Signature

Parent/Guardian Verification

Make a Donation to Premier Academy