KDC Teacher Application

Date:
How did you hear about us?

Personal

*Social Security Number: --

Birthday:
//

*First Name: *Last Name:

*Address:

*City: *State:
*Zip Code:

*Home Phone: --
Cell Phone:
-- Fax: --

E-Mail:

In Case of Emergency, Contact:

Name:

Relationship:

Address:

City: State:
Zip Code:

Home Phone: --
Work Phone:
--

Education

Years Attended

Name of School Location (City, State) From To
Year Graduated

Course, Major Subjects or Degree

High School:

Higher Education:

Other:

High School and College Activities in which you participated

Dance Experience (Type of experience, where, number of years, etc.)

Child Care/Teaching Experience (Dance Schools, Sunday School, Camp, Nursery, Day Care, Baby-sitting, etc.)

Family Status (Student, Live with parents, Married, Spouse, etc.)

Children and Child Care Arrangements

Weekday Morning and Afternoon Hours Available to Work (Select all that apply)
	Monday	Tuesday	Wednesday	Thursday	Friday
AM
PM

Work History (List all employment, starting with present or most recent employment)
Employer 1
Name of Present or Last Employer: Type of Business:
Address:
Start Date:	Leaving Date:	Job Title:
Starting Pay:	Final Pay:	Reason for Leaving
Supervisor:	Title:	May We Contact?	Yes No
Description of Work and Responsibilities:

Employer 2
Name of Next Previous Employer: Type of Business:
Address:
Start Date:	Leaving Date:	Job Title:
Starting Pay:	Final Pay:	Reason for Leaving
Supervisor:	Title:	May We Contact?	Yes No
Description of Work and Responsibilities:

Other Information

Personal References
Reference 1
Name:			Occupation:
Address:
City:		State:	Zip Code:
Phone:	--
Reference 2
Name:			Occupation:
Address:
City:		State:	Zip Code:
Phone:	--
Reference 3
Name:			Occupation:
Address:
City:		State:	Zip Code:
Phone:	--

KDC Privacy Policy

Personal
*Social Security Number: --				Birthday:	//
*First Name:				*Last Name:
*Address:
*City:			*State:	*Zip Code:
*Home Phone:	--	Cell Phone:	--	Fax:	--
E-Mail:
In Case of Emergency, Contact:
Name:				Relationship:
Address:
City:			State:	Zip Code:
Home Phone:	--	Work Phone:	--

Education
		Years Attended
Name of School	Location (City, State)	From	To	Year Graduated	Course, Major Subjects or Degree
High School:
Higher Education:
Other:

The Kid's Dance Company Online Teacher Application Copyright © 2002 The Kid's Dance Company. All rights reserved. Revised: May 31, 2010

The Kid's Dance Company Online Teacher Application
Copyright © 2002 The Kid's Dance Company. All rights reserved.
Revised: May 31, 2010