Portland Application 
 

 

Name
Street Address
City, State, Zip

It is important that we be able to easily reach you to verify your application.  Please give us adequate information that will facilitate contact during normal working hours.
Home phone
Work phone
Cell phone
E-mail (required)
Best method of contact
Best time to contact me
How did you hear about us

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.
What experience do you have working with children (paid or volunteer)?  Include ages, hours per week and number of weeks/months/years spent in each activity.
Summarize your experience with science.
Tell us about yourself
Why do you think you would be a good Mad Scientist?
We are looking for people who are seeking part-time work.  Tell us why a part-time job suits your current employment situation.
What do you see yourself doing 2 years from now?
What would friends say are your best qualities?
What would friends say are your worst qualities?
What is your level of education?  

Being a Mad Scientist requires that you have access to a reliable vehicle, a valid driver's license and current vehicle insurance?

Yes, I have access to a car, valid license and vehicle insurance.


How many afternoons per week (between 1:30 and 5:30) do you have available for work?      afternoons per week

Current occupation

Attach your resume in Microsoft Word format here (".doc" extension)

Please list 3 references and contact information (include at least one professional reference)
  Contact Phone Relationship (eg: former employer)
1) 
2) 
3) 
Please feel free to add any other information about yourself that you feel may help us better understand you and your personal skills/abilities and goals.