Name:*
Home Phone:*
Cell Phone:
Email: *
Complete Address: *
Job Preference:
Choose one:
Days Available:
Hours Available:
Salary Expectation:
What areas of the city can you work in?
Besides childcare, what household duties are you willing to perform?
Education:
Last grade completed:
HS Diploma/GED:
School Attended/Location:
College, Trade, Business:
Courses Taken:
Degrees / Certificates Received:
Special Training in Childcare:
Languages spoken:
CPR?
Date:
First Aid?
Date:
Swim?
Hobbies / Activities:
Years of childcare experience:
Years of infant experience:
What do you like most about being in the childcare profession?
Describe your personality:
Tell us about yourself:
Employment:
Employer:
Position held:
Duties:
Dates of employment:
Salary:
Reason for leaving:
Employer:
Position held:
Duties:
Dates of employment:
Salary:
Reason for leaving:
Employer:
Position held:
Duties:
Dates of employment:
Salary:
Reason for leaving:
Other Childcare References if Different from Above:
Name:
Duties:
Position Held:
Dates of employment:
Reason for leaving:
Name:
Duties:
Position Held:
Dates of employment:
Reason for leaving:
Name:
Duties:
Position Held:
Dates of employment:
Reason for leaving:
