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Walden Day Care Centre

Staff Application Form
First
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Last
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Address
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Phone Number
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Email Address
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Date Available to Commence Employment
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Education
High School
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Grade Completed
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Post Secondary
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Diploma/Degree Received
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Other Courses
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Employment Background
Employer 1
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From (date)
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To (date)
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Employer 2
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Employer 3
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Employer 4
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Child Care /Early Learning Experience (ie: field placements)
Facility 1
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Facility 2
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Facility 3
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Facility 4
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References (please provide three professional references!)
Name
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Occupation
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Telephone
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Name
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Occupation
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Telephone
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Name
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Occupation
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Telephone
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Documents Required for Employment at Walden Day Care Centre Inc (Please check all that apply to you)
Current Criminal Reference Check (within 3 months)
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Up to date immunization record
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Confirmation that you have received a two-step TB Test
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A note from a physician stating that you are Free off Communicable Disease
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If deemed "qualified" or "otherwise approved" a copy of your diploma or degree
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Anaphylaxis Training (confirmation that you have received it)
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A copy of your First-Aid/ CPR training (with expiry date)
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WHMIS Training (and confirmation that you have received it)
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Other Information
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Upload Resume
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Captcha Captcha
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