Keys to Life Educational Advantage Employment Application Employment Application Full Name: Last First: Middle: Address: Apartment/Unit # City: State: Zip Code: Phone: Email: Date Available: Social Security Number: Desired Salary: Position Applied For: Are you a citizen of the United States? Yes No If no, are you authorized to work in the U.S.? Yes No Have you ever been convicted of a felony? Yes No If yes, explain: Education High School: Address: From To Did you graduate? Yes No Diploma: What is your expertise in the field of teaching you are applying for? Please list three professional references. Full Name: Relationship: Company: Phone: Address: Full Name: Relationship: Company: Phone: Address: Full Name: Relationship: Company: Phone: Address: A Background check will be conducted in the interest of the student’s safety. Military Service Branch: From: To: Rank at Discharge: Type of Discharge: If other than honorable, explain: Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Print: Date: Submit
