Resource Center for Child Care


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Application

 

 Last Name First Name
Address Gender

Male Female

City 18 Years or Older

Yes No

State Criminal Record

Yes No

Zip - Email

Phone # --ext# Alt. Phone # --ext#

Education

GED

Current Employer

High School Diploma Employer Phone # --ext#

Some College

May we contact your employer?

Associates Degree

Previous Experience

Related Training

Bachelors Degree
Masters Degree
Position Desired Director Date Available
Assistant Director Location (s) Desired
Administrator
Teacher Age Preference

    Infant

Toddler
Assistant Teacher Preschool

School

House keeper

Any

Cook Part Time or Full Time

Full Time

Bus Driver

Part Time

AM
PM
Babysitter Substitute

Name 5 Qualities

that Describe You

Honest

Explain Why You Want To Work With Children

Dependable
Hardworking
Optimistic

Additional

Information

Reserved
Outgoing
Responsible
Observant

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