Name:

City:

Email address:

Phone number:

Contact me during:

How did you hear about us?:

Are you looking for full-time or part-time work?:

Do you have a reliable car you can use for work? (ESSENTIAL for the role):

Which afternoons are you available to work in term time? (Tick at least 3)

I am available every afternoon from 2:30pm onwards

At least three but need to confirm my schedule

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

Highest level of education obtained: High school 6th Form CollegeCollege or University degreePost Graduate Study

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!

Have you performed or presented in front of people before?:

Do you have experience working with children?:

Tell us about your experience of / interest in science:

Please add any other information about yourself:

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):