17. Home #:
18. Work #:
19. Email: *
20. Address
21. Health Care #: *
:
22. Doctor's Name *
23. Doctors Phone Number: *
Other Information
24. Language(s)
Check all that apply.
English
Spanish
Sign
Other:
25. Driver's Licence
Files submitted:
26. Comments
:
Emergency Contact - Other than Paren
Guardian
27. Full Name (First, Last Name) *
28. Address
29. Email:
30. Cell: *
31. Home #:
:
nt /
32. Work #:
Disclosure Statements (Man
33. Must check o% all boxes to proceed
Check all that apply.
I agree to attend mandatory unpaid
I agree to review company policies a
follow all rules and guidelines.
I promise to report any inappropriat
activities occurring regarding Employee
Harassment and Student Abuse (neglec
physical, sexual, emotional or drug use)
If I am scheduled for a closing shift
promise not to leave a student unattend
they are in the care of their parent/guard
I will make sure program sites/facili
always properly kept and presentable fo
visitors. No items will be out of place on
depart my closing shift.
I will communicate any requested p
off with 24 hours notice. I understand th
miss more than 7 days within (1 session
losing my position with Allegories of Me
School.
I will make arrangements to be avai
special events (such as theater arts prod
and holiday recitals). I agree to be prese
to 5 special events (unpaid; which may o
during the week or on Saturdays) if I am
responsible for program/performance
facilitation.
:
ndatory)
d: *
training.
and
te
ct,
t, I
ded until
dian.
ities are
or
nce I
paid days
hat if I
n). I risk
e After
ilable for
ductions
ent for up
occur
m
If I am an INSTRUCTOR, I am able to
curriculum for my sessions (which will b
submitted at least 30 days prior to sessi
date).
I will not share any con?dential info
about Allegories of Me After School plan
programming efforts unless otherwise
authorized to share.
I acknowledge that I have completed th
application accurately to the best of my
knowledge. I will return to the Allegories
Website to verify my understanding of t
company's expectations.
34. Type Name (First, Last Name) *
35. Application Date
Example: January 7, 2019
This content is neither created nor endorsed by Go
Forms
:
o draft
be
ion start
ormation
ns or
his
y
s of Me
the
oogle.
: