Employment Application

Position Applying For*
First Name*
Last Name*
Date
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Preferred Contact Method, please select all that apply.
- Email
- Text
- Phone
EMPLOYMENT HISTORY
Employer #1
Employer Name & Address Position Dates of Employment Reason for Leaving
Employer #2
Employer Name & Address Position Dates of Employment Reason for Leaving
Employer #3
Employer Name & Address Position Dates of Employment Reason for Leaving
EDUCATION
Highest Level of Education (or Grade) Completed
List
School (high school, college, other) Degree or grade completed Course of Study (major, degree)
INFORMATION NEEDED FOR EMPLOYMENT CONSIDERATION
Do you have a vehicle to use on the job?
If you have a child enrolled in one of our programs, select the program below.
- Head Start or Early Head Start
- Pre-K Counts
- Child Care
- Center for School-age Development
- Summer Camp
Have you ever worked for SUMMIT Early Learning before?
- Yes
- No
If yes, what position and when?
PROFESSIONAL REFERENCES
Please list the names of three persons familiar with your character, ability, or education for more than one year. Do not include friends or relatives.
Professional Reference #1:
NAME, ADDRESS, PHONE NUMBER, EMAIL ADDRESS OCCUPATION PROFESSIONAL RELATIONSHIP TO APPLICANT
Professional Reference #2:
NAME, ADDRESS, PHONE NUMBER, EMAIL ADDRESS OCCUPATION PROFESSIONAL RELATIONSHIP TO APPLICANT
Professional Reference #3:
NAME, ADDRESS, PHONE NUMBER, EMAIL ADDRESS OCCUPATION PROFESSIONAL RELATIONSHIP TO APPLICANT
Please specify any restrictions regarding contacting your current employer:
List any other experiences not previously listed, such as volunteer work, that are relevant to the position for which you are applying:
Why are you interested in working for SUMMIT Early Learning?
How did you hear about this position?
- SUMMIT Employee
- Friend / Family
- Facebook
- Indeed
- LinkedIn
- Website
- Hiring Sign
- Other
If you were referred by a current SUMMIT employee, please enter their name here.
Resume & Cover Letter (if applicable)
Drop files here or

Max. file size: 300 MB.
Please upload Resume and Cover letter here.
Condition of employment application:*
I have read and understand the below statements,
I UNDERSTAND THAT:
1. Any false or incomplete information in my application may be reason for denying employment, or if employed, termination from employment.
2. SUMMIT Early Learning, Inc. may contact my former employers and professional references to determine any acceptability for employment. I release anyone who provides information and SUMMIT Early Learning from any and all liability and responsibility by reason of their so doing.
3. If I am selected for a position, I am aware that by law I must apply for and receive a clearance check from the Pennsylvania State Police, FBI, and from the Pennsylvania Department of Human Services, the child abuse state registry. Application must be made at time of acceptance of job offer.
4. All new employees beginning employment 1/1/86 or later must abide by PA ACT 33, amended by ACT 80, and any future amendments.
5. I further understand that this is an application for employment and that no employment contract is being offered.
Applicant Certification*
I understand the below statement.
IF HIRED, MY EMPLOYMENT MAY BE TERMINATED IF I HAVE BEEN NAMED AS THE PERPETRATOR OF A FOUNDED REPORT OF CHILD ABUSE LONGER THAN 5 YEARS AGO OR THE PERPETRATOR OF AN INDICATED REPORT OF CHILD ABUSE.
Phone
This field is for validation purposes and should be left unchanged.

SUMMIT Early Learning requires current and valid Background Clearances.

Employer Name & Address	Position	Dates of Employment	Reason for Leaving

School (high school, college, other)	Degree or grade completed	Course of Study (major, degree)

NAME, ADDRESS, PHONE NUMBER, EMAIL ADDRESS	OCCUPATION	PROFESSIONAL RELATIONSHIP TO APPLICANT

EMPLOYMENT APPLICATION

EMPLOYMENT HISTORY

EDUCATION

INFORMATION NEEDED FOR EMPLOYMENT CONSIDERATION

PROFESSIONAL REFERENCES

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