CAAEYC Scholarship Employer Reference
Please complete each question, if applicable.
- Name of Applicant:_________________________________________
- Date Form is Completed by Employment Supervisor:
______________________________________________________
- Name of Program of Employment:
- Address of Program: ________________________________________
- Phone number of program: ___________________________________
- Name of Program Director (Employment Supervisor):
______________________________________________________
Employment Supervisor Phone Number(s) and Best Time(s) to be Contacted:
______________________________________________________
- Employment Position (administrator, teacher, teacher aid, group supervisor, child care provider, other):
______________________________________________________
- HowLong has the Applicant been Employed with the Program? __________
- Is this Applicant Employed at least 20 Hours a Week? _________________
- Comments regarding this applicant? _____________________________
______________________________________________________
______________________________________________________
______________________________________________________
- Signature of Employment Supervisor:
______________________________________________________
______________________________________________________
