Verification of Employment Form - Early Learning Coalition of the 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with SECTION 1: EMPLOYEE/CONTRACTOR INFORMATION. Fill in the employee's name and Social Security Number (SSN). This section is crucial as it identifies the individual applying for School Readiness services.
3. Proceed to SECTION 2: EMPLOYER INFORMATION. Enter the employer's name, phone number, and address. Ensure accuracy as this information will be used for verification.
4. In SECTION 3: WORK SCHEDULE AND PAY, provide details such as hire date, rate of pay, total hours worked per week, and whether the position is seasonal or temporary. Indicate days worked and any additional compensation like tips or bonuses.
5. If there are changes in work schedule or pay, complete SECTION 4 with the relevant details including date of change and new rate of pay.
6. For employment termination details, fill out SECTION 5 with the termination date.
7. In SECTION 6: MEDICAL LEAVE, indicate any medical leave dates and reasons if applicable.
8. Finally, complete SECTION 7: EMPLOYER CERTIFICATION by providing the employer’s name, title, signature, and date to certify that all information is accurate.

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