Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone

Home Phone

Email

Best time to contact you?

How did you hear about us?

Desired Pay Rate

When are you available to start?

If hired, would you have a reliable means of transportation to and from work? (Explain)

Do you have regular access to a computer, the Internet and a printer?

Yes
No

Can you lift 35 pounds?

Yes
No

Typically, our after school classes are held Mon-Friday during the time frame of 1:30-5:30 (actual time depends on the specific school site, each class is 1-2 hour with 15 minutes of set up and 15 minutes of clean up). Please list the specific hours you would be available for each day:

Monday	Tuesday	Wednesday	Thursday	Friday

We offer after school instructors very part-time work. Teaching time is about 1.5 hrs per class. Generally our instructors work 2-3 days per week for a total of 3-7 hours per week. Ideally, how many days of the week would you like to work?

Birthday Parties and other special events are typically held outside of these hours/days with many occurring on the weekends. Are you interested in working these events as they become available? Weekend Availability:

Saturday	Sunday

Please answer the following questions:

Tell us about yourself:

Please summarize your prior experience with children:

Please summarize your experience with art:

How do you feel about working with children for a 6 hour period?

You will be working very closely with other teachers. How difficult is it for you to take directions from another adult?

How do you feel about working with handicapped/special needs children? Experience?

Kids say the darnedest things! Can you keep personal or embarrassing family information confidential? Not to be shared anywhere or discussed outside of work. This does not include abuse or neglect which MUST be reported to your supervisor immediately.

What do you see yourself doing 2 years from now:

Tell us why you think you would make a great KidzArt instructor:

Current Employment, Position & No. of Years:

Highest level of education completed:

College Information (if applicable):

Are you at least 18 years old?*

Yes
No

If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?*

Yes
No

References

Please list 2 references; include at least one professional reference.

Name	Phone Number	Relationship

How many hours of work are you seeking per week*

Are you looking for full-time or part-time work*

Full-time
Part-time
Either

Employee's Agreement: If I am interviewed and considered for a position, I am aware that your policies include an Investigative consumer report (Background Check) will be requested in connection with an offer of employment. That you follow the policies and guidelines of all the schools or orgaanizations where we work with children, throughout the United States. A background check showing no felonies, violence, or criminal misdemeanors will be required. No incident(s) involving physical or sexual abuse of a child will be acceptable for employment consideration. If such a report is requested, and in response to a written request from me, KidzArt will inform me of the name and address of the consumer reporting agency which furnished the report. I certify that the information I have provided is true and that I have not knowingly withheld any fact that would affect my application. Any mirepresentation, falsification or willful omission in any detail shall be sufficient reason for refusal of employment or dismissal after employment regardless of time. If employed by KidzArt, I agree to conform to the rules of KidzArt and I agree and understand that my employment can be terminated, with or without cause, and with or without notice, at any time, at the option of either KidzArt or myself. I understand that no executive other than the owner(s) of the KidzArt franchise area has any authority to enter into any employment agreement for any specified period of time.*

Accept

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Instructor Application

Please answer the following questions:

References

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