Stretch-n-Grow ONLINE APPLICATION
DESIRED LOCATION
Central Bucks Area
(Doylestown, Chalfont,
Warrington)
Montgomery County
(Ft. Washington, Dresher)
Upper Bucks County
(Quakertown, Perkasie, Hilltown,
Silverdale, Blooming Glen)
Montgomery County
(Indian Valley - Souderton,
Telford, Franconia, Harleysville)
POSITIONS APPLYING FOR
Preschool Fitness Coach
Sports Coach
Dance
Cheerleading Coach
PERSONAL INFORMATION
Name (Last, First, Middle Initial)
Address
(Street, City, State, Zip Code)
Email Address
Home Phone #
Cell Phone #
Are you at least 18 years of age?      
Have you ever been convicted of a felony or subjected to a deferred adjudication on a felony charge?
yes                                        no
no                                yes   If "Yes", please explain in detail in comments section below.
EDUCATION  Did you graduate from highschool or receive GED?
yes                     no
Names of College/University                                 Dates Attended                Type of Degree                        Major            Actual or Expected Graduation  
#1
#2
#3
REFERENCES List references who are NOT related to you and are NOT previous supervisors
Name                                                Type of Reference                                        Telephone                                        Email Address
#1
#2
#3
EMPLOYMENT HISTORY List starting with the present/most recent employer.
Employer                                          Address                                   Supervisor                                        Telephone
#1
Dates Employed (Mo/YR)                                Salary                                Position                                Duties                                   
Full-time             Part-time, hrs/wk.                              May we contact for references?                        Reason for leaving                  
YES                NO             
Employer                                          Address                                   Supervisor                                        Telephone
#2
Dates Employed (Mo/YR)                                Salary                                Position                                Duties                                   
Full-time             Part-time, hrs/wk.                              May we contact for references?                        Reason for leaving                  
YES                NO             
Employer                                          Address                                   Supervisor                                        Telephone
#3
Dates Employed (Mo/YR)                                Salary                                Position                                Duties                                   
Full-time             Part-time, hrs/wk.                              May we contact for references?                        Reason for leaving                  
YES                NO             
PLEASE READ CAREFUL AND PROVIDE FIRST, MIDDLE, AND LAST NAME INITIALS
I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I
understand that any misstatement, falsification, or omission of information may be grounds for refusal to authorize investigation of my previous
employers and my personal background and release all parties from all liability for any damage that may result in furnishing information to you.
Applicants Initial:
Date:
Applicants Signature (signature required at interview date)
Are you currently CPR certified?                             Are you curently 1st Aid Certified                         Had you had a TB test within the last year?
YES                NO                                                                YES                NO                                                                YES                NO