Preschool Lab Supervisor Skills Survey
Name: ______________________________________________ Date: _______________________
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):
Preschool Literacy Development
Elementary Education Teacher
Lead Teacher of Preschool Room
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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