Oak Meadow Montessori School

Educational Alternatives, Inc.
2145 Collins Hill Road,
Lawrenceville, GA30043

Tel:(770)963-8303 Fax:(770)963-8422


Application for Employment

Yes No 

Yes No 

What kind of Visa classification do you have?

Yes No 
Please explain


List any experience you have had with children (Indicate ages of children, your duties, dates worked in the position, reasons for leaving):
Have you had CPR/First Aid training within the last three years?
Yes No 

Annual Child Care Training courses are required by the state. Are you willing to participate?
Yes No 


A ten year comprehensive employment history is required by the state for all child care employees. Please list employment history for the past ten years, beginning with your most current or last employer. If you have been unemployed during any time within the past ten years, list how you spent your time, e.g. student, housewife, unemployed, etc. If you need additional space, please use separate employment record form.

May we contact your present employer?
Yes No 
Are you in all respects able to perform adequately the job duties for which you are applying?
Yes No 
Do you have a criminal record?
Yes No 
Have you ever been shown by credible evidence (A court order or jury, a Department Investigation, or other reliable evidence) to have abused, neglected, or deprived a child or adult or to have subjected any person to serious injury as a result of intentional or grossly negligent misconduct?
Yes No 

Under the Americans with Disabilities Act of 1991, this program is required to reasonably accommodate individuals with a disability. The reasonable accommodation requirements apply to the application process, any pre-employment testing, interviews and actual employment, but only if the program supervisor is made aware that an accommodation is required. If you are disabled and require accommodation, you may request it at any time during the interview process. You are obligated to inform the program director of your needs if it will impact your ability to perform the job for which you are applying.

I certify that all the information on this application is correct. I have not given any false statement concerning my qualification requirements.

It is the policy of Oak Meadow Montessori School to be non-discriminatory in all its hiring practices. We hire qualified individuals without regard to religion, race, color, gender, sexual orientation, disability, age or national origin, provided they meet the requirements established in our personnel policy.