Caregiver Employment App

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Employment Application

Full Name

Phone Number

Address

City, State

Date of Birth

A High School Diploma or GEDCurrent CPR/First Aid TrainingLicensed Child Care Experience

When is the best time to call you?

What would you do in the following situation: You are in a classroom helping a child tie their shoe. Behind you back you hear arguing. You turn around to see John holding a toy; and, Sally crying. What would you do and why?

To work in a Child care facility, you must pass a background check. Is there anything on your background that may come up? If so, please explain the situation.

In Order to do a Background check, please provide the following State Licensed Identification Number

What State was your Identification from:

Height

Weight

Eye Color

Hair Color

City and State of Birth

Gender

MaleFemale

Do you have children that would attend the child care center? Please give their names and date of birth

Email Address

Text

Social Security number

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