Daycare Employment Application

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Daycare Employment Application2020-12-12T23:07:56-05:00
  • DAYCARE EMPLOYMENT APPLICATION

  • 8491 CHAMBERLAYNE ROAD, RICHMOND, VA 23227 | (804) 262-7104

  • We consider applicants for all positions without regard to race, color, gender, national origin, age, disability, marital or veteran status. However, applicant must be a Christian and a tithing member of a local church.

  • Education

  • Indicate any foreign languages you can speak, read and/or write.
  • Employment References

  • Employment Experience

  • Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, gender, national origin, disabilities, or any other protected status.

  • Additional Information

  • Specialized Skills

  • By signing below, I authorize FLM to obtain information, written, oral or other, from any law enforcement agency, or other persons with knowledge of such information, bearing on my character, mode of living, criminal background. FLM reserves the right to conduct this inquiry at any time.

  • I hereby affirm that the information provided on this form is true and complete. I understand that the information is subject to verification and that making a materially false statement or affirmation is a Class I misdemeanor.

  • Clear
  • Please Return to: Faith Landmarks Ministries 8491 Chamberlayne Road, Richmond VA 23227 Ph: (804) 262-7104 | Fax: (804) 266-7127

    Dear Pastor /Church Administrator,

  • has applied for employment at our Daycare.

    To assist us in making an appropriate selection, we would appreciate your time in completing this Pastoral Reference on the above candidate and their family. Should any unforeseen issues arise, we may request your assistance regarding this candidate's conduct while employed at our Daycare. (Please have this information filled out prior to submitting to your Pastor).

  • PASTOR: PLEASE FILL OUT, SIGN AND RETURN AS SOON AS POSSIBLE

    (This may be delegated to other administrative personnel)

  • FLM Daycare-Teaching and Learning Without Compromising the Word of God

  • PROSPECTIVE EMPLOYEE/STAFF HEALTH REPORT

  • Physician's Statement

  • INSTRUCTIONS: The top portion of the form should be completed by the employee; the bottom portion must be completed and signed by the physician, physician's assistant, or licensed nurse practitioner. The signature of an R.N. or L.P .N. is NOT acceptable. Staff must have this form completed and submit it on an ANNUAL basis.

  • This statement is signed in compliance with the Code of Virginia, Section 63.2-1716.

  • -----------is free from any disability which would prevent him/her from caring for children.

  • PHYSICIAN/NURSE PRACTITIONER'S SIGNATURE:

  • Clear
  • Should be Empty:
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