Type of Employment Sought: for Center Use Only

Type of Employment Sought: For Center Use Only: _____ Full-time Date Center _____ Part-time Received ______Substitute Interviewed ______Summer Only Started ______Volunteer Terminated ______Date Available ______

Application For Employment

Carriage House Childrens Center The Childrens Center of Pittsburgh

Name______Cell Phone______

Address______Zip______Telephone______

Person(s) to Notify in an Emergency ______Telephone______

Email ______

EDUCATION/TRAINING (List highest level first) Major/ Degree/ Date Name Address Minor Diploma Completed

______

WORK EXPERIENCE (Begin with the most recent and mark volunteer experience with a V to the left of the line) Start/End Reason for Name of Employer Address Dates Leaving

______

______The Carriage House Childrens Center and its affiliates are equal opportunity employers.

PROFESSIONAL REFERENCES (List three individuals who can attest to your qualifications for the position for which you are applying)

Name Address Telephone Relationship

______

SPECIAL TALENTS OR INTERESTS

______

MEMBERSHIPS AND /OR PROFESSIONAL AFFILIATIONS (List those that relate to the position for which you are applying)

______

Why are you interested in working at The Center? ______

______

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses?

Yes ______No _____ If yes, explain: ______

______

Return application to: __ Carriage House Childrens Center __ The Childrens Center of Pittsburgh 5604 Solway St. 327 Craft Ave. Pittsburgh, PA 15217 Pittsburgh, PA 15213 412-421-0300 412-641-1990 412-421-3127 (Fax) [email protected]