PHILADELPHIA
32º MASONIC LEARNING CENTER FOR CHILDREN
1700 Tomlinson Road, Philadelphia, PA 19116
TRAINEE APPLICATION
Please complete the following information and attach copies of all required documentation.
Name _________________________________________ Date ________________________
Address _____________________________________________________________________
City _____________________________________ State ________ Zip _________-_______
Telephone: Day (_____)_____________________ Evening (_____)_____________________
Email _______________________________________________________________________
Academic History (Begin with Highest Degree)
Degree _________ Institution ___________________ Date ____________ Maj. __________
Degree _________ Institution ___________________ Date ____________ Maj. __________
Degree _________ Institution ___________________ Date ____________ Maj. __________
Please submit proof of a Bachelors Degree (copy of diploma or transcript showing degree
and date awarded).
Other Credits _________________________________________________________________
____________________________________________________________________________
Please submit a description of any multisensory training you have had. Include principal trainer, institution, address, dates, total hours, coursework hours, practicum hours, and ages taught. Submit copy of Certificates or other proof of completion.
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Multisensory experience: _______________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________
List on a separate sheet any Conferences/Workshops/Courses you have attended. Include any presentations you have given.
Please submit your current résumé. Include professional societies to which you belong and two letters of recommendation from persons knowledgeable about your professional