Employment Application

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Employment Application

ABC Children’s Academy and 
Developmental Center, Inc.
Owners: Kirk and Dana Warren
Admin Email: dana.warren@myabcca.com
Pope County Director Phone: 479-968-5048
Yell County Director Phone: 479-229-2000
Johnson County Director Phone: 479-647-5080
Admin Fax: 479-280-1176

Employment Application Rev. 02-20
Please answer each question fully and accurately. No action can be taken on this application until all questions have been answered. Please print except for your signature on the last page.

Are you at least 18 years of age?
Which do you prefer to work?
Please fill in the hours each day that you are available to work.
MondayTuesdayWednesdayThursdayFriday
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(1)
Have you ever worked for ABC Children’s Academy before?
Do you have a checking account for Direct Deposit of your Paycheck?
Has a court ever denied you parent custodial or visitation rights as a result of child neglect or maltreatment?
Have you ever been convicted or have charges pending of a criminal offense of any kind?
Do you have any limitations that would restrict job performance or that would put children at risk?
Are you or your spouse a registered sex offender?
Do you acknowledge that the use of marijuana either medically or recreationally while working in a childcare is not allowed according to Article 98 of the Arkansas Constitution?
Would you take a physical examination if required?
Are you now or have you ever used illegal drugs?
Would you be willing to take a drug screening?
Are you now or do you expect to be engaged in other business or employment?
Educational History
Type of SchoolName of SchoolCity & StateMajorYears CompletedDate & Degree Earned
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(1)
ReferencesName, complete addresses, and phone numbers of the people we may contact about you. No relatives or former employers, please.
NamePhoneComplete Address
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(1)
Employment HistoryList your last 6 years of employment: employers, assignments, or volunteer activities, starting with your CURRENT or most recent employer, including military experience.
Ref. Ck (Office Use Only)Employers NameFromToDutiesSupervisors nameSupervisors PhoneReason for Leaving
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(1)
In Case of EmergencyName, Complete Address, home & work phone numbers of the person we may call in case of an emergency:
Name Complete AddressHome #Work #
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(1)

AFFIDAVIT: I CERTIFY THAT EVERYTHING IN THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT MISLEADING OR INCORRECT STATEMENTS OR CONSEQUENTIAL OMMISSIONS MAY RENDER THIS APPLICATION VOID, OR IF EMPLOYED, WOULD BE CAUSE FOR TERMINATION. I AUTHORIZE THE INDIVIDUALS OR INSTITUTION RELEASING THEM FROM ALL LIABILITY FOR ISSUING SUCH INFORMATION.

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