Form

Please fill out all the entries and click submit at the end of the form

Please read Carefully

www.vipbabysitting.com

Section 1: General Information

First Name:*

last name*

Street address

City

Zip

E-mail:*

Confirm Email*

Alteranate Email

Phone

Cell Phone

When can you start?

- Month - Day Year

at

/ Hour Minutes

DICLOSURE

All VIP BABYSITTING SOLUTIONS INC contractors are required to undergo a Department of justice background check. Is there anything you would like to disclose at this time

Upload Resume

Section 2: Background and Experience

Are you CPR or first aid cerified

Do you have Valid Driver's License

Education

Briefly Describe your Educational Background

Employment History

Briefly Describe your Professional history working with children.

Employment History

Personal or professinal references ( Please Provide six) Combinations is Fine !

1. Name/Title

Reference Phone

2 Name/Title

Reference Phone

3. Name/Title

Reference Phone

4. Name/Title

Reference Phone

5. Name/Title

Reference Phone

6. Name/Title

Reference Phone

Section 3: Personal Information

List Experience with

Infants and Toddlers, Children with Special needs ( e.g Autism,Wheel chair bound, hearing impaired

Managing Children. How many children, ages 3 and up are you comfortable handling in 8- hour period

Volunteer work and Hobbies, Please list any volunteer work you have done, and briefly describe your hobbies

Physical and Medical

Physical condition, are you able to lift 30 lbs repeatedly over the course of the work shift?*

Physical explanation if you answered No to above question, Please provide brief explanantion

Medical condition, Do you have any medical conditions that would impact how you perform your work?*

Mecical explanation, If you answered yes to above, please briefly describe

Personality and Outlook

How would your friends describe you?

How would your previous employer describe you?

Additional Remarks?

Background Check Authorization

Upon completion of interview and reference check you will be required to get figerprinting to run the background check ( including criminal history and sex offender data base ) . Please check the box below to indicate that you understand and agree to comply with this request. You will be provided with information as to where to get fingerprinting done.

Background Check Authorization*

Agree

E-mail