Application

Playful Hearts ChildCare, LLC

Providing fun, loving, educational care!
We may be looking for you!

Please complete the form below to apply for a position with us.

Contact Information
Full Name: *

First Name Middle Name Last Name
Nickname:
Current Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Best number to reach you at: *

Area Code Phone Number
Email Address: *
Email Validator *

What you are looking for
Position applying for: *
Date available to start: *

Month Day Year
Desired Wage: *
Desired Shift or Hours:
Desired Age Group:
If you have an age group you feel most comfortable with, please list.
Looking for:

Full-time 30+ hours per week Part-time 20-30 hours per week Part-time 20 hours or less per week Volunteer- Drop in and help anytime based on applicants availability

Education
Registry Level: *
Choose level on your last printed certificate
Education: *
Choose all that apply
List name(s) of college(s) attended and dates.
Official Transcript from College will be required for verification within 30 days hire.
College Diploma or Certificate:

Browse Files

Cancel of
List related continuing education course/trainings. Include dates of completion
Copies of course work completion will be required during interview process.

Employment History
Please start with current or most recent employment and work your way back, listing all employment for the last 3 years. For periods of unemployment, list dates and "unemployed" or "attending school." All periods of time over the last 3 years must be accounted for.

*Optional for Volunteers to complete. It is always helpful, so we know a little about our volunteers.
Upload Resume
If uploading resume and including last 3 years of employment, you do not need to complete Employment history.
Previous Employment 1
Previous Employment 2
Previous Employment 3
Previous Employment 4
Previous Employment 5

References
Reference 1 *
Reference 2 *
Reference 3 *

Criminal Background Information
All applicants must pass a criminal background check annually, which includes a fingerprint background check upon hire and before beginning work with children, as of October 2018.

Yes

In the last 5 years, have you been arrested for, charged with, or convicted of,
been imprisoned, been on probation, or been on parole for any offense(s)? Include all offenses where you have been found guilty, pled guilty or nolo contendere (no contest). (Leave out traffic fines of less than $150.00.)

Have you been convicted by a military court-martial in the past 5 years?

Are you now under charges for any violation of law?

During the last 5 years, have you been fired from any job for any reason, did you quit after being told that you would be fired, or did you leave any job by mutual
agreement because of specific problems?

Have you ever been arrested for or charged with a crime involving a child?

Have you ever been found guilty of or entered a plea of nolo contendere (No contest) or guilty to any felonious offense, or any of two or more misdemeanor offenses under Federal, State, or tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact or prostitution; crimes against persons; or offenses committed against children?

In the last 5 years, have you illegally used any controlled substance, for example marijuana, cocaine, crack cocaine, hashish, narcotics (opium, morphine, heroin, etc..), amphetamines, depressants (barbiturates, methaqualone, tranquilizers, etc..), hallucinogenic's (LSD, PCP, etc..), or illegally used prescription drugs?

In the last 5 years, have you been involved in the illegal purchase, manufacture, trafficking, production, transfer, shipping, receiving, or sale of any narcotic, depressant, stimulant, hallucinogen, or cannabis, for your own intended profit or that of another?

Please use this space to provide additional information for any questions that you may have answered yes to.

Submit Application
Enter the message as it's shown *
E-signature

Clear
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Playful Hearts ChildCare, LLC

We may be looking for you!