Interested in employment in the Child Development Laboratory School? Fill out this application for consideration. Email First Name * Last Name * Address * Address Phone Number * Email * Major * Year in School * --- Freshman Sophomore Junior Senior 5th yr Senior Questions As required by DHS, a criminal history and child abuse background check is completed on all staff. Have you ever been convicted of a crime that may make you ineligible for employment?* Questions No Yes If so, please explain: Current Certifications Infant/Child CPR: Infant/Child CPR Expiration date: First Aid: First Aid Expiration date: Mandatory Child Abuse Reporting Mandatory Child Abuse Reporting Expiration date: Other Other Expiration date: Are you willing to work in the kitchen? Yes No Are you eligible for work-study? Yes No Can you work during spring break? Yes No Can you work during summer semester? Yes No Can you work during any other breaks? Yes No Please describe your experiences with young children: Please list your class schedule below (days/times of courses):* * First non-relative reference First Name * Last Name * Address * Phone * Email * Relationship * Second non-relative reference First Name * Last Name * Address * Phone * Email * Relationship *