Teacher/Playgroup Facilitator at AMS

First Name *

Last Name

Email *

Phone *

Resume *

Cover Letter

Have you ever applied to or worked for Lotus Bloom? *

If yes, when and for which position?

If hired, would you have a reliable means of transportation to/from work? *

Are you at least 18 years old? *

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? We comply with the ADA and consider reasonable accomodation measures that may be necessary for eligible applicants to perform essential functions. *

If no, please describe the functions that cannot be performed.

Do you have a relative or personal relationship with a current employee of Lotus Bloom? We may refuse to hire relatives of present employees if doing so could result in actual or potential problems in supervision, security, safety or morale, or if doing so could create a conflict of interest. *

Name of Most Recent Employer *

Supervisor Name & Contact Information (phone/email)

Start Date

End Date

May We Contact This Employer for a Reference? *

I certify that I have not knowingly withheld information that might adversely affect my chances for employment and the answers given by me are true and correct to the best of my knowledge. (please type name) *

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Application Form