Name:

City:

Email address:

Phone number:

Contact me during:

How did you hear about us?:

This postion is Part-Time, does this work for you?:

Please enter your general availability (days of the week and times):

Do you have regular access to a reliable car?:

Select the position(s) for which you are applying

After School Program Instructor

Highest level of education obtained: Some high schoolHigh school or equivalentSome college or universityCollege or university degreeSome graduate studiesGraduate degreeOther

Current occupation:

Attach your resume here (.doc, .docx, .pdf, .zip only. The .rtf files won't work!):

Please answer the following questions as completely and honestly as you can. The more information we have regarding your strengths, weaknesses, intentions, expectations, etc., the more accurately we can assess whether or not Mad Science is right for you! Don't Worry, not having experience in something will not disqualify you!

Tell us why you feel you would be a great Mad Scientist...:

Do you have experience working with groups of children?:

What are your hobbies/interests?:

What would other people say are your biggest strengths and weaknesses?:

Please list 3 references and contact information (include at least one professional reference).

1st Reference

Contact name:

Phone number:

Relationship (eg: former employer):

2nd Reference

Contact name:

Phone number:

Relationship (eg: former employer):

3rd Reference

Contact name:

Phone number:

Relationship (eg: former employer):