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Have you had any accidents or driving violations?
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If yes, please explain below.
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Did you graduate High School?
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GED
Did or do you attend college and if so, please list the college's name?
What year did you or do you anticipate graduating?
Type of degree you are pursuing?
Major/Minor desired.
Current GPA
How many years of experience do you have working with children in any capacity?
I am experienced with the following ages:
Newborn to 9 months
9 months to 24 months
2 to 5 years old
5 to 10 years old
10+ years old
In what capacity do you have childcare experience?
Private Babysitting
Relatives
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Preschool Teacher
Teacher
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Tutor
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If Other, please explain below.
Please check ALL that apply.
Drive a Car
Will Transport Children
Will Assist in Overnight Care
Able to Swim
CPR Certified
First Aid Certified
Will Work Around Animals
Will Work with Parent at Home
Know Sign Language
Speak a Foreign Language
If you speak a Foreign Language, which one?
Are you fluent?
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No
Date Available to Start
Days Available
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How long are you willing to commit?
Select
6 months
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How many hours do you desire per week?
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40 hours
Please describe any scheduling limitations or considerations for the next 12 months. Include current work and/or school schedules.
Please briefly describe some personal interests and hobbies you have.
Please briefly describe the type of caregiver you consider yourself to be.
Ex: Lenient, structured, etc...
How did you hear about Preferred ChildCare, Inc.?
As a part of our service to our families, we will conduct a criminal background check, a motor vehicle report history, a social security trace, and a sexual offenders check. Do you give us permission to run these checks?
Yes
No
By signing below, you certify that these statements are accurate and true. If you are hired by Preferred Childcare, Inc. as a ChildCare Specialist, you agree to notify Preferred Childcare, Inc. if any changes to your contact information are made.
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