QCNC Staff Application Form

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Are you 21 years old or older? If not, please stop here. 21+ years old is our minimum age requirement.*
When would you like to start a new position?*
Job Skills & Training
Tell us about your professional experience and what you are looking for:*
Postpartum DoulaNewborn Care SpecialistRN or LPN with 2+ years of specific infant experienceLactationMultiplesPostpartum Mood Disorders
South Charlotte/MatthewsSouthparkFort Mill/Rock HillCentral CharlotteLake NormanConcord
References

Please list three (3) professional references that showcase your night nanny, NCS, PPD, or nursing experience.
Reference 1
Name:*

First NameLast Name
Contact Information (email or phone)
What was your role and length of time with this family?
Reference 2
Name:*

First NameLast Name
Contact Information (email or phone)
What was your role and length of time with this family?
Reference 3
Name:*

First NameLast Name
Contact Information (email or phone)
What was your role and length of time with this family?
What is your required hourly rate?
Are you looking for full or part time work?
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