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All staff must meet high standards of professionalism and safety. |\n| --- |\n| APPLICANT INFORMATION\u003Cbr>● Full Name:   \u003Cbr>● Preferred Name/Nickname:   \u003Cbr>● Phone Number:  \u003Cbr>● Email Address:  \u003Cbr>● Current Address:  \u003Cbr>● City/State/ZIP:  \u003Cbr>● Are you legally eligible to work in the U.S.? ☐ Yes ☐ No |\n| POSITION DETAILS\u003Cbr>● Available Start Date:  \u003Cbr>● Availability:\u003Cbr>☐ Before School ☐ After School ☐ Summer Camp ☐ Both |\n\nEDUCATION & CERTIFICATIONS  \n● High School:    \n● College/Other:    \n● CPR/First Aid Certified? ☐ Yes ☐ No  \n● Other Certifications:    \nCHILDCARE / SPORTS EXPERIENCE  \nPlease describe any experience working with children, coaching, or leading youth activities:  \n\n| EMPLOYMENT HISTORY\u003Cbr>Please list your previous employment beginning with the most recent.\u003Cbr>1. Employer Name:   Location (City/State) :   Position/Title:   Dates Employed: From   To   Primary Duties:   Reason for Leaving:   |\n| --- |\n| 2. Employer Name:   Location (City/State) :   Position/Title:   Dates Employed: From   To   Primary Duties:   Reason for Leaving:   |\n\nREFERENCES ( Non-family)  \n1. Name:   Phone:   Relationship:   Years Known:    \n2. Name:   Phone:   Relationship:   Years Known:    \n\n| BACKGROUND CHECK & DISCLOSURE\u003Cbr>All employees are required to pass a background check prior to hire.\u003Cbr>☐ I hereby authorize Hustle Athletic Academy to conduct a criminal background check, including child abuse registry checks, and contact former employers or references to verify qualifications.\u003Cbr>☐ I understand that employment is contingent upon the results of this background check.\u003Cbr>Have you ever been convicted of a felony, assault, or any crime involving a child or vulnerable person?\u003Cbr>☐ No\u003Cbr>☐ Yes – please explain:\u003Cbr>A prior conviction may not automatically disqualify you from employment, but failure to disclose one will. |\n| --- |\n| MANDATORY REPORTING AGREEMENT\u003Cbr>As a licensed childcare provider, Hustle Athletic Academy staff are mandatory reporters of suspected child abuse or neglect, as defined by Virginia law.\u003Cbr>☐ I understand that I am legally required to report any suspected abuse or neglect of a child to the appropriate authorities.\u003Cbr>☐ I agree to comply with all mandatory reporting laws and Hustle Athletic Academy policies. |\n\nAPPLICANT SIGNATURE  \nBy signing below, I affirm that the information provided on this application is true and complete. I understand that any false or misleading information may result in disqualification or dismissal.  \nPrinted Name:   Signature:    \nDate:","cbCairogZNjRyXQH","https://ap.wps.com/l/cbCairogZNjRyXQH","pdf",152770,"English","# Applicant Information\n# Position Details\n# Education & Certifications\n# Childcare / Sports Experience\n# Employment History\n# References (Non-family)\n# Background Check & Disclosure\n# Mandatory Reporting Agreement\n# Applicant Signature","[{\"question\":\"What information does the form collect about the applicant?\",\"answer\":\"It collects full name, preferred name/nickname, phone number, email address, current address, city/state/ZIP, and whether the applicant is legally eligible to work in the U.S.\"},{\"question\":\"How does the form handle work eligibility and availability?\",\"answer\":\"It asks if the applicant is legally eligible to work in the U.S. and requests the available start date and availability options (before school, after school, summer camp, or both).\"},{\"question\":\"What authorizations and disclosures are required before hire?\",\"answer\":\"Applicants must authorize criminal background checks (including child abuse registry checks) and contact former employers or references. They also disclose whether they have ever been convicted of a felony, assault, or any crime involving a child or vulnerable person.\"}]","Employee Application Form - Hustle Athletic Academy | PDF",1789827652]