NeuroNest Application Form
At NeuroNest, we believe every child deserves a caregiver who understands them, respects them, and helps them thrive — especially those who are neurodivergent. If that speaks to your heart, you’re in the right place.
Contact Details
Name
*
First Name
Last Name
Pronouns
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Basic Information
Please Upload Picture
*
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of
Birth Date
*
-
Month
-
Day
Year
Date
Do you have a driver's license?
*
Yes
No
Are you open to emergency or short-notice bookings?
*
Yes
No
Are you looking for occasional, part-time, or full-time hours?
*
Occasional
Part-time
Full-time
What days and times are you available to work?
*
Su
Mon
Tues
Wed
Thur
Fri
Sat
6:00-8:00am
8:00am-11:00am
11:00am-1:00pm
1:00pm-3:00pm
3:00pm-5:00pm
5:00-7:00pm
7:00pm-9:00pm
9:00pm-11:00pm
11:00pm-1:00am
1:00am-3:00am
3:00am-6:00am
Education
High School
*
Yes
No
Name / City
College
*
Yes
No
Major
Name / City
Date of Graduation
-
Month
-
Day
Year
Date
Work Experiences
What is your experience working with children?
*
Have you worked with neurodiverse children or those with autism? If so, please describe.
*
How do you handle meltdowns, transitions, or sensory overload?
*
Are you CPR and First Aid certified? If not, are you willing to become certified?
*
Name of Employer #1
*
First Name
Last Name
Phone Number
*
Age of Children
*
Name of Employer #2
*
First Name
Last Name
Phone Number
*
Age of Children
*
Resume Upload
Browse Files
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of
Style & Strengths
How would you describe your caregiving style?
*
What strategies or tools have you used to help a child feel calm and safe?
*
What makes you a good fit for working with children with different needs or communication styles?
*
Are you comfortable following family-specific routines or using communication aids (visual schedules, AAC devices, etc.)?
*
Scenarios
A child becomes overwhelmed and starts to cry or scream—what do you do?
*
A parent has given precise instructions, but the child seems to want something different. How do you handle it?
*
You’re unsure about a behavior or something that happened during your time with the child. What’s your next step?
*
Commitment and Values
What drew you to apply for this position?
*
Are you able to commit to consistent care (same child/family) for 3+ months?
*
What do you hope to gain from this experience?
*
Are you willing to complete a background check?
*
Is there anything else you’d like us to know?
Submit
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