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Night Owl Kids Care, LLC.

Application for Independent Contractor
Night Owl Kids Care, LLC. provides equal employment opportunities (EEO) to all independent contractors and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Night Owl Kids Care, LLC. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Position Details:

This position is contract care with Night Owl Kids Care, LLC. and will take place at the Milton Hershey School.

We will be providing group care to children of employees at Milton Hershey School while they complete trainings.

Please display your availability for the following shifts*

	Yes, Available	Not Available
10/29/25 8:15a-12:45p
10/30/25 7:45a-5:15p
11/3/25 8:15a-4:15p
11/4/25 7:45a-5:15p
11/5/25 7:45a-1:15p
11/10/25 7:00a-2:45p
11/12/25 8:15a-12:45p
11/13/25 8:15a-5:15p
11/14/25 8:15a-4:45p
11/17/25 8:15a- 4:45p
11/18/25 8:15a- 4:45p
11/20/25 9:15a-4:45p
12/01/25 8:15a-3:45p
12/03/25 7:15a-2:45p

Are you available for at least 10 of the 14 shifts listed above?*

Yes, I am fully available for 10 or more shifts listed above.No, I am not fully available for 10 or more shifts listed above.
Do you understand that staff are not allowed to bring their own children to work? Childcare is only for the registered employees of Milton Hershey School.*

Yes, I understand that I cannot bring my own child(ren) to this jobsite. It is not allowed.No, I do not understand. I will need to bring my child to work and do not have childcare of my own.
Message: We are sorry, however, we are seeking staff that are available for at least 10 of the 14 shifts listed above, and staff that understand that staff's own children are not allowed to attend childcare. If you answered "No" to one of those questions, we are unable to proceed with reviewing your application.

We appreciate your interest and welcome you to apply to future opportunities.

Thank you,

Night Owl Kids Care, LLC.
Applicant's Personal Contact Information
Full Name*

First NameMiddle NameLast Name
E-mail*
We will be corresponding with you via email, so please provide one that you check frequently.
Phone Number*

Area CodePhone Number
Your Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Which positions interest you? Please note that all positions are contract (1099) and less than part-time hours. (Check all that apply)*

Childcare Worker for Hershey, Pa area (PRN)Childcare Worker Lead for Hershey, Pa area (PRN)Special Event Childcare Worker for Pa area
Event Childcare: In what location(s) are you able to work events?

MassachusettsMarylandNew YorkVirginiaWashington D.C.PennsylvaniaOther
Can you pass a background check (Pa Child Abuse History, Pa State Police Criminal History, FBI Criminal History)?

YesNoI have received clearance within the past 12 months
Are you legally authorized to work in the United States?*

YesNo
Do you have a valid government issued ID?

YesNoOther
Are you currently certified in Pediatric and Adult CPR/ First Aid/ AED Training?*

YesNo, but I am prepared to complete this training with NOKC
If you are currently certified, please attach a copy of your Pediatric and Adult CPR/First Aid Card saved as "Last Name First Name CPR"

Upload a File
If you experience difficulty or issues uploading an item to the form. Please submit the form without the uploads and email the documents to apply@nightowlkidscare.com at a later time. Cancelof
Are you fluent in speaking, reading, and understanding English?*

YesNoSomewhat
Do you speak any other languages than English? List here: *
Are you fluent/proficient in American Sign Language?*

YesNo
What is your current employment status?*

Working Full timeWorking Part TimeAttending SchoolNot currently workingOther

Are you interested or available to working future sessions for childcare at Milton Hershey School?

	Yes, I would like to work the full session	I will be partially available	I will not be available
01/26/26-02/27/26
03/30/26-05/08/26
07/27/26-09/04/26

Are you available to work weekday shifts that occur between the hours of 7:30am and 5:00pm? (most shifts will be 6 to 8 hours long)*
Do you have access to reliable transportation?*

YesNo
Applicant's Capabilities
When answering these questions, please select scenarios that are optimal for your lifestyle and what you can accomplish comfortably and with certainty.
Please tell us the type of children you have cared for in the past and on your own:*

NewbornsInfantsToddlersPre-SchoolSchool-agedThose with ADD/ ADHDThose who are Medically FragileThose with Physical DisabilitiesThose with Autism Spectrum DisorderThose with Developmental Delays
Select any of the following actions for which you are able to complete without strain or difficulty:*

Sitting on the floorCrawling/ playing on the floorHolding up to 40 lbs.Bending over and picking up children
Are you comfortable working in an environment where children are of diverse faiths, cultures, ethnicities, and familial backgrounds/structures?

YesNo
Have you had any experience working any of the following roles?*

TeacherTeacher's AideCDAChildcare WorkerBabysitterHealthcare workerNannyNone
Please additionally explain your different experiences you've had working with children with various needs:*
Education and Certifications
Please select all diplomas you have attained and/or your current education status:*

GEDHigh School DiplomaAssociate's DegreeBachelor's DegreeGraduate's Degree
Please list the schools from which you graduated, attended, or currently attend. Start with High School*
Are you certified in the any of the following?*

Pediatric & Adult First Aid/ CPR trainedChild Development AssociateAny childcare training courses from the state or federal systemsAny Early Childhood Education CoursesOther
If you possess any additional certifications that you feel apply to this job, please explain/list here:
Please upload your documentation for each of your certifications that are listed above:

Upload a File
If you experience difficulty or issues uploading an item to the form. Please submit the form without the uploads and email the documents to apply@nightowlkidscare.com at a later time. Cancelof
Past Employment

List your current/most recent job first
Please list your employment/volunteer history (List your current or most recent position first):*
If you were dismissed from any of the above positions, please explain the circumstances here:
Please attach your resume here with related childcare and/or volunteering experience for the past 10 years (education & other jobs should be listed as well):

Upload a File
If you experience difficulty or issues uploading an item to the form. Please submit the form without the uploads and email the documents to jmcgregor@nightowlkidscare.com at a later time. Cancelof
Additional Questions
Have you ever been accused of abuse or maltreatment towards someone of a vulnerable population (child under 18 years, elderly, or mentally/physically disabled person) in your care, professionally or personally? (Include founded and unfounded)*

YesNo
Have you ever been investigated for the abuse or maltreatment of a person of a vulnerable population? (Include founded and unfounded)*

YesNo
As an adult (18 years & older), have you ever had a consensual relationship with someone under the age of 16 years?*

YesNo
If you answered "yes" to any of the previous three questions, please explain the circumstances, details, and outcome for each:
References
List at least three professional references (These references cannot be relatives or personal friends, and will need to be prepared to answer questions on your character, qualifications, and professionalism). If you fail to provide three professional references, your application will not be given further consideration*
Please describe why you would be an exceptional addition to the Night Owl Kids Care team:*
If you are offered the position, would you be able to complete online training and attend training and/or orientation central to your local area?

YesNo
Please tell us your size in Adult Unisex T-shirts? Shirt should fit comfortably, enabling you to bend and reach without skin showing.
By signing below, I agree that I have honestly provided true and factual information for the independent contractor position at Night Owl Kids Care, LLC. I also understand that all information provided to Night Owl Kids Care, LLC. is confidential. I further understand that false or misleading information provided by me will result in a determination of ineligibility for or release of the position with Night Owl Kids Care, LLC.
Signature
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Night Owl Kids Care, LLC.

Applicant's Personal Contact Information

Applicant's Capabilities

Education and Certifications

Past Employment

Additional Questions

References