CALGARY APPLICATION
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Community
How many children would you like to care for?
What type of home do you live in?
Please Select
House
Condo
Basement
Apartment
Duplex
Other
Do you have a yard?
Yes
No
If so, is the yard fenced?
Yes
No
Do you currently rent or own your home?
Rent
Own
What age of children would you prefer to care for? (Please note that care of one year olds is highly sought after.) Choose all that apply.
1-2 years
3-5 years
Grade 1 and above
All
Days and Times Available
Rows
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Early Morning (5 - 7)
Work Hours (9 - 5)
After School (2-7)
Evening (7 - 9)
Late night (9 - 11)
Overnight Care
Do you have any pets? If so what kind?
Are you a non-smoking household?
Yes
No
Please describe your previous childcare experience and level of education.
When would you like to start your dayhome?
-
Month
-
Day
Year
Date
Do you have a current CPR certification?
Yes
No
Date of expiry (if applicable)
-
Month
-
Day
Year
Date
Do you have a current police check in a vulnerable sector?
Yes
No
Date of issue (if applicable)
-
Month
-
Day
Year
Date
Please provide the name of your current or future Dayhome.
Are you currently or have you ever worked with an agency before?
Yes, I am currently with an agency
Yes, I have worked with an agency before
No, I have never worked with an agency
What kinds of play/childcare equipment do you own if any?
Are you willing to transport children?
Yes
No
What makes you interested in becoming a Dayhome Educator?
Please give some examples of activities you may do with the children.
Do you have children of your own? (Please state names, ages, and genders.)
Are you currently caring for children other than your own?
Yes
No
How would you rate your home for cleanliness?
Have you ever worked with another Dayhome Agency?
Email
example@example.com
Comments or Questions
Submit
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