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First Name *

Last Name *

Address *

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Are you eligible to work in the United States? *

Yes   No

If you are under age 18, do you have an employment/age certificate? *

Yes   No  If yes, please explain:

POSITION/AVAILABILITY:

Position Applying For *

Team Leader   Site Coordinator   Enrichment Teacher

Available to Work in

South Los Angeles   Inglewood

Area of Expertise

Personnel Managment    Math   Science   Literacy/English/Reading/Writing   Public Speaking   Arts & Crafts

Days Available *

Monday   Tuesday   Wednesday   Thursday   Friday   Saturday   Sunday   Any

Hours Available *

AM   PM  For specific Day/Hour availability, please enter information below.

What date are you available to start work? *

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I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.

Do you agree with the terms and conditions? *

Yes, I agree.

Date *

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