Childcare Worker Application

Childcare Worker Application

Apply to join our childcare center team. Please complete all sections honestly and thoroughly. Required fields are marked.
Minimum Requirements
- Must be at least 18 years old
- Must have reliable transportation
- Must be able to pass a background check
- Must be dependable and able to arrive on time
- Must enjoy working with children
Do you meet ALL of the ABOVE requirements?
“Thank you for your interest, but you do not meet the minimum requirements for this position

Position & Availability
Which position are you applying for?
Are you willing to work a consistent weekly schedule?
Are you available Monday through Friday during typical childcare hours (6:00 AM – 6:00 PM)?
Please list any schedule restrictions or limitations.

Weekly Availability

Personal Information
Full Name (First, Middle, Last)

First NameMiddle NameLast Name
Preferred Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid cell phone number.Format: (000) 000-0000.
Is this a smartphone?
Email Address
example@example.com
Which location do you live closest to?
Date of Birth

MonthDayYear
Date
Emergency Contact Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.

Background Check
Have you EVER been charged or convicted of any criminal offense (excluding minor traffic violations)?
Please explain:
Are you willing to complete a background check and fingerprinting as required by state regulations?
We conduct a preliminary background check as part of our screening process. Final employment decisions will follow full state-required background procedures.

Employment History
Are you currently employed?
Current Employer
Current Position
Current Employer Contact Person
Current Employer Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
May we contact your current employer?
Previous Employer Name
Previous Position
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Reason for leaving
Upload Resume

Cancelof

References

Must provide a minimum of 2
Reference 1 Name
Reference 1 Relationship
Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 Email Address
example@example.com
Reference 2 Name
Reference 2 Relationship
Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Email Address
example@example.com
Reference 3 Name
Reference 3 Relationship
Reference 3 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 Email Address
example@example.com

Final Agreement
By submitting this application, I confirm that all information provided is accurate and complete. I understand that false or misleading information may result in disqualification or termination.
Typed Signature (Full Name)
Date

MonthDayYear
Date
Should be Empty:

Position & Availability