LEADER IN TRAINING APPLICATION Part-time/Seasonal Employment PERSONAL INFORMATION Name: _______________________________________________________________________ E-mail address: _________________________________________ (Last) (First) (M.I.) Please use your email, not a parent/guardian Address: ____________________________________________________________________________ Phone: Home _____________________________________ (Street) (City) (Zip) Cell phone: ___________________________________________ Your Will you be 16 or older as of 6/9/2017? _____Yes _____ No Your Student ID Number: EDUCATION Formal Education School Name Current Grade Recreation or Child Development Related Courses Taken HIGH SCHOOL PAID OR VOLUNTEER EXPERIENCE Employer or Agency Supervisor Address City Phone Dates Covered 1. ( ) Duties: ( ) 2. Duties: REFERENCES Please provide at least one teacher, counselor, principal or other school related adult as a reference – Name Relationship Telephone Their email (teacher, etc.) 1. 2. (OVER)
LEADER IN TRAINING APPLICATION Part-time/Seasonal Employment PERSONAL INFORMATION Name: _______________________________________________________________________ E-mail address: _________________________________________ (Last) (First) (M.I.) Please use your email, not a parent/guardian Address: ____________________________________________________________________________ Phone: Home _____________________________________ (Street) (City) (Zip) Your Cell phone: ___________________________________________ Will you be 16 or older as of 6/9/2017? _____Yes _____ No Your Student ID Number: EDUCATION Formal Education School Name Current Grade Recreation or Child Development Related Courses Taken HIGH SCHOOL PAID OR VOLUNTEER EXPERIENCE Employer or Agency Supervisor Address City Phone Dates Covered 1. ( ) Duties: 2. ( ) Duties: REFERENCES – Please provide at least one teacher, counselor, principal or other school related adult as a reference Name Relationship (teacher, etc.) Telephone Their email 1. 2. (OVER)