Skip to Main Content
About
Back
Early Years
About Early Years
Child Care Resource and Referral
Our Name
Our History
Our Impact
Careers
People
Leadership
Board of Directors
The Latest
Blog and News
Events and Trainings
For Families
Back
Child Care Help
Child Care Help for Families
Find Child Care
Evaluate Child Care
Pay for Child Care
Learn About Child Care
Types of Child Care
Choosing Quality Child Care
Steps to Finding Child Care
Paying for Child Care
Tax-Based Assistance
State and Local Programs
Child Care Scholarship Program
Resource for Families
Early Childhood Homelessness
Downloadable Resources
FAQs for Families
For Early Educators
Back
Scholarship and Salary Supplements
STEP$
TEACH Early Childhood® North Carolina
Child Care WAGE$®
Program Development
Technical Assistance
Professional Development
Child Care Referral Central
Community Initiatives
Early Childhood Homelessness
spoonFULL
Child and Adult Food Care Program
NC Birth-to-Three Quality Initiative
Healthy Social Behaviors Initiative
Our Research
Back
Early Care and Education Research
Our Research
Early Care and Education Studies
Statewide ECE Workforce Studies
Conduct a Workforce Study In Your State
Resources
NC ECE Data Repository
Explore Resources
TEACH National Center
Contact
Explore Programs
Search
Donate
Find Child Care
Early Years Employment Application
Employment Application
Early Years Employment Application
Personal Data
Title of the position you are applying for?
First Name
*
Middle Name
Last Name
*
LIST OTHER NAMES used in past 7 years; including birth names, maiden names, and A.K.A’s.
Home Address
*
Home Address
Home Address
Home Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Number of Years at Current Address (If less than 7 years, list all other cities and states which you lived during the past 7 years.)
*
Previous Address
Previous Address
Previous Address
Previous Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Previous Address
Previous Address
Previous Address
Previous Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Previous Address
Previous Address
Previous Address
Previous Address
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Email
*
Cell Phone Number
*
Home Phone Number
Additional Phone Number
Date of Birth
*
Are you at least 18 years of age?
*
Yes
No
Other than a minor traffic offense, have you ever been convicted of a crime? This includes allegations of and/ or substantions of sexual or physical abuse and neglect of a child. (A conviction record will not necessarily bar you from employment.)
*
Yes
No
IF YES, provide details below, including date and location of offense.
Are you legally eligible for employment in this country? (Proof of Eligibility will be required upon employment)
*
Yes
No
Have you ever applied with Early Years previously?
*
Yes
No
If YES, when?
Have you ever received services from Early Years?
*
Yes
No
If YES, do you have any outstanding debts with Early Years?
*
Yes
No
Do you have any relatives presently employed with Early Years (formerly Child Care Services Association)?
*
Yes
No
Name of Early Years Employee
Relation
Job Title
Position
Position Desired
*
Salary Expected Per Month
*
Please include desired dollar amount per month.
What date are you available?
*
mm/dd/yyyy
Are you willing to travel?
*
Yes
No
If YES, any restrictions?
*
Yes
No
Are you willing to relocate?
*
Yes
No
If Yes, any restrictions to relocating?
*
Work Availability
*
Full Time
Part Time
Shift Work
Drivers License Number
State Issued
Expiration Date
Class
Last 4 digits of Social Security Number (123-45-XXXX)
*
Employment History
Present or Last Employer
May we contact your current employer for a reference? (Required)
*
Yes
No
Hours per week
Company Name
*
From (month/year)
*
To (month/year)
*
City and State
*
Phone (with area code)
*
Type of Business
*
Ending Salary
Position Title
*
Reason for Leaving
*
Name of Supervisor
*
Title of Supervisor
*
Supervisor’s Phone Number
2nd Previous Employer
May we contact for a reference?
*
Yes
No
Hours per week
Company Name
From (month/year)
To (month/year)
City and State
Phone (with area code)
Type of Business
Ending Salary
Position Title
Reason for Leaving
Name of Supervisor
Title of Supervisor
Supervisor’s Phone Number
3rd Previous Employer
May we contact for a reference?
*
Yes
No
Hours per week
Company Name
From (month/year)
To (month/year)
City and State
Phone (with area code)
Type of Business
Ending Salary
Position Title
Reason for Leaving
Name of Supervisor
Title of Supervisor
Supervisor’s Phone Number
Military Experience
Branch
Final Base, City & State where assigned
Date Entered
Date Discharged
Rank & Position at Discharge
Name of Supervisor
Title of Supervisor
Supervisor’s Phone no.
Did you receive a dishonorable discharge?
Yes
No
Education
Name of High School, City and State
*
Degree Received
Year Received
Major and Minor Fields of Study
Name of College, City and State
Degree Received
Year Received
Major and Minor Fields of Study
Other Education, City and State
Degree Received
Year Received
Major and Minor Fields of Study
Other Education, City and State
Degree Received
Year Received
Major and Minor Fields of Study
Additional Qualifications
List professional licenses, registrations, certifications, including state of issuance and expiration dates.
List languages in which you are fluent other than English.
List additional skills or abilities.
Professional References
Name
*
Name
First Name
First Name
Last Name
Last Name
Phone Number
City, State
Positon
Name
*
Name
First Name
First Name
Last Name
Last Name
City, State
Phone Number
Positon
Name
*
Name
First Name
First Name
Last Name
Last Name
City, State
Phone Number
Positon
Submit
If you are human, leave this field blank.
Δ
How We Help
Families
We provide resources for families to find, evaluate, and pay for child care services .
Find Childcare
Get referrals to local child care programs.
Evaluate Childcare
Assess the quality of programs near me.
Pay for Childcare
Find financial assistance to supplement childcare costs.
All Resources for Families
How We Help
Early Educators
We offer a wide range of services to the integral part of the child care system: providers.
Education Scholarships and Salary Supplements
Helping early educators learn more and earn more.
Program Development
Coaching, technical assistance, and professional development.
Community Initiatives
Health, wellness, and social support for child care programs.
All Programs for Early Educators
Improving Child Care Through
Research
Our research team conducts comprehensive studies and maintains education data.
Data Repository
Data and fact sheets on the early care and education system.
ECE Studies
Our studies on childhood systems and the child care workforce.
Statewide Workforce Studies
Providing information to policymakers and program creators.
Explore Our Research