* Required Information
First Name
*
Last Name
*
Email
*
Phone Number
*
Do you have a High school diploma? Do you have proof of it?
Yes
No
Do you have a clean background? If not, is any felonies over 10 years old and any misdemeanors over 3 years old from final disposition?
Yes
No
Do you have a valid driver's license? Do you have a car? If not do you have reliable transportation?
Yes
No
How old are your children?
Are they currently attending any other childcare center?
Yes
No
If you qualify for publicly funded childcare will you allow your children to enroll while you work?
Yes
No
Are you physically fit and can lift approximately 40lbs?
Yes
No
This position is every week 10pm to 6am the days may vary. You are paid weekly.
Yes
No
Are you currently working?
Yes
No
If so, where?
Days and Hours
How long have you been employed?
Are you ready to start within the next two weeks?
Question/Comment: