Preschool Lab Supervisor Skills Survey
Name: ______________________________________________ Date: _______________________
Position: __________________________________________________________________________
This information becomes part of your application. Your skills, expertise, and education will be rated based on
your answers. Please fill out this form as completely as possible. Under columns three through six, check the
category that best shows the depth of your experience. Do not check more than one column per line.
Years of relevant experience:
Check Degrees (Attach Transcripts):
Full time work
HS/GED
Part time work
Certificate
Area
Associate
Major
Bachelor
Major
Model/
Version
Used
Years of
Experience
Training
only (1)
Preformed
with help
(2)
Performed
unaided
(3)
Instructed
others (4)
Computers:
PC
Macintosh
Professional Skills:
Curriculum Development
Preschool Literacy Development
Infant Teacher
Toddler Teacher
Preschool Teacher
Elementary Education Teacher
Lead Teacher of Preschool Room
Volunteer Teaching
Budget Development
Elements of Maintaining Safe
Environment for Children
I have answered the above information to the best of my knowledge.
Signature: ______________________________________________ Date: ________________________
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