Child Nutrition Assistant Application
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Child Nutrition Assistant
Items denoted with a red asterisk
*
are required.
1.
First Name
*
2.
Last Name
*
3.
Address
*
4.
Do you have a Driver's License?
*
Yes
No
5.
Home Phone
6.
Cell or Alternate Phone
*
7.
Email Address
*
8.
Employment Desired?
*
Full-time Only
Part-time Only
Full - or Part-Time
Employment Desired
9.
What is the highest level of education that you completed?
*
Name and Location
Graduate? - Degree?
Major/ Subjects of Study
High School
College or University
GED
Specialized Training, Trade School, etc...
10.
Employment History
*
Employer Company
Position/Duties
Pay
Supervisor Name
Supervisor Phone Number
Supervisor Email
Currently Employed at Company?
Reason for Leaving?
Can we contact supervisor?
Most Recent Employer
Former Employer
Former Employer
Former Employer
11.
List two personal references with contact information.
*
Name
Telephone
Email
Occupation
Relationship
Reference One
Reference Two
12.
List 3 Work Related References
*
Name
Telephone Number
Email Address
Occupation
Reference One
Reference Two
Reference Three
13.
Please List your areas of highest proficiency, special skills or other items that may contribute to your abilities in performing the child nutrition position.
*
14.
Types of computers, software, and other kitchen equipment you are qualified to operate or repair.
*