SJs Friends Childcare Teacher Application

SJs Friends Childcare Teacher Application

Please complete this form to its entirety.
Personal Information

Please provide your basic details.
Full Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Education and Qualifications

List your educational background and relevant qualifications.
Highest level of education completed*
List all relevant degrees, diplomas, or coursework (include institution and year)
Relevant Certifications

Indicate any certifications you hold.
Please select the certifications you currently hold

CPR CertificationFirst Aid CertificationShaken Baby Syndrome Prevention TrainingSIDS Risk Reduction TrainingChild Abuse and Neglect Mandated Reporter TrainingOther
Please upload copies of your certificates (if available)

Cancelof
Work Experience in Childcare

Provide details of your relevant work experience.
Do you have experience working with youth/children on the autism spectrum?*

YesNo
List your experience working in childcare settings (include employer, position, dates, and duties)*
References

Provide at least two professional references.
Reference 1: Name, relationship, phone, and email*
Reference 2: Name, relationship, phone, and email*
DCF Compliance and Disclosures

Answer the following to demonstrate compliance with Wisconsin DCF regulations.
Are you willing to undergo a background check as required by DCF?*

YesNo
Are you able to meet DCF health requirements (including physical exam and immunizations)?*

YesNo
Have you ever been convicted of a crime or had a substantiated finding of child abuse or neglect?*

NoYes (please explain below)
If yes, please provide details:
Acknowledgment of DCF Childcare Standards and Policies

Please read and acknowledge your understanding.
Are you comfortable working with children on the autism spectrum?*

YesNo
Should be Empty:

SJs Friends Childcare Teacher Application

Personal Information

Education and Qualifications

Relevant Certifications

Work Experience in Childcare

References

DCF Compliance and Disclosures

Acknowledgment of DCF Childcare Standards and Policies