Employment Application

Full Name *

First

Middle

Last

Aliases/Prior Names

First

Middle

Last

(Includes all names by which an applicant is currently known or has been identified as)

Other Aliases/Prior Names

First

Middle

Last

Maiden Names as well (Includes all names by which an applicant is currently known or has been identified as)

Are you at least 21 years of age? *

Email *

Phone *

Current Physical Address *

Address Line 1

Address Line 2

City

State

Zip Code

Current Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

If you have lived out of state for the past 5 yrs, enter previous address here

Address Line 1

Address Line 2

City

State

Zip Code

Enter prior addresses for last 5 years.

Available to Start *

Hourly Wage Expectations *

Our positions are part time and pay ranges from $8.50/hr-$11/hr and based upon work experience and certifications

Position Details

Position(s) Applying For: (You can check more than one) *

Van Drivers need to be at least 21 years of age. You must have a valid drivers license and clean driving record. A CDL is NOT required.

Will you be able to obtain a Mississippi State Department of Health Certificate of Immunization Compliance Form 121. *

Yes.
No,

Form 121 (Immunization Compliance) can be obtained from your doctor, county health departments, or be downloaded online

Are you a citizen of the US *

Have you ever been convicted of a crime? *

Certifications

Do you have a valid drivers license? *

Should we hire, we will need a copy of your drivers license, SSN and 121 Immunization Form

Do you have a valid CPR certification? *

Yes.
No,
No, but would be willing to get certified.

During all hours of operation, including the arrival and departure of children, a child care facility employee shall be present who holds a valid CPR certification, at any location where the children are present

Do you have a current CECPR Child Development Associate (CDA) credential, a MDHS DECCD Child Care Director’s Credential, or MDHS OCY Director’s Child Care Credential *

Yes.
No,
No, but would be willing to get these credentials.

Do you have a valid Food Manager's Certification such as MSU TummySafe or National Restaurant Association, Inc., i.e., ServSafe? *

Yes.
No,
No, but would be willing to get these credentials.

Availability

Amount of Work Hours desired weekly *

We do not have full time jobs available. Our positions are part time. 15-30 hrs. per week depending on what time of year and if the school is out on breaks

Which days are you available between 2:00pm-6:15pm?- Our work hrs may vary *

Are you available to work during the summer months? *

Are you available to work full day schedules during spring break, Christmas and other school intercession weeks? *

Education

Do you have a high school diploma or equivalent (GED)? *

Yes.
No,

Please tell us about your education, degrees and certifications. Please list years and places of attendance *

Experience

Are you currently employed? *

List Current Employer, address, phone and supervisor *

if you are not employed, put N/A

Employment History- List last three jobs, positions, dates worked *

Do you have at least 3 years prior documented experience caring for children who are under 13 years of age and who are not related you? *

Yes.
No,

Staff failing to meet the requirements of education and/or experience to act as a caregiver shall be designated as caregiver assistants.

If you are applying to be a teacher, how many years of experience do you have? What Ages have you worked with?

Do you have any experience working with special needs children?

If you are applying as a tutor, what subjects can you teach and how many years experience do you have as a tutor?

Would you be able to drive a 15 passenger van from school pickup to the center each day? *

Yes, I have a CDL Drivers license and can confidently transport passengers
Yes. I have a valid drivers license and a clean driving record and feel confident I can safely transport children
No, I do not feel comfortable driving the van to transport children
No, I have medical concerns and on medication that would keep me from being able to safety drive the children
No, I have do not have a clean driving record and am concerned I might not be the best fit for transporting children

A CDL license is not required to transport children in a 15 passenger van.

Please tell us about any experience you have working with children. *

Have you worked with children in a Biblical setting, church, Sunday School, Vacation Bible School? Tell us about this. *

Volunteer Activities and Professional Memberships *

Especially in regards to children or work in your community or local church.

Please list all instruments you play and music experience. *

If you are not applying as a music teacher, just put N/A.

Professional References who can speak to your work ethic and moral character. please include contact info. (Do not include relatives) *

I hereby certify that all the information provided in this employment application is true and complete. I understand that false information or the omission of information may disqualify my candidacy and may be grounds for termination. I further understand that I am applying to a Drug Free Workplace and may be required to submit to testing for the presence of drugs as a condition for employment. *

I hereby certify
I do not hereby certify

Fishers of Men has my permission to perform all criminal records checks, Driver record (when applicable) a Child Abuse Central Registry Check, a Sex Offender Registry check and contact previous employers and all personal references. *

I give my permission
I do not give permission

Upload your Resume if you have one

Click or drag a file to this area to upload.

How did you hear about this position?

Apply below for our part-time positions

Position Details

Certifications

Availability

Education

Experience