Employment Verification Form for Child Care
Employee Details
Employee Name
First Name
Middle Name
Last Name
Job Position/Title
Department
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer Details
Employer Name
Employer Phone Number
Format: (000) 000-0000.
Employer Email
example@example.com
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employment Details
Start Date
-
Month
-
Day
Year
Date
End Date (leave it blank if employee still works here)
-
Month
-
Day
Year
Date
Salary per year ($)
Salary per quarter ($)
Salary per month ($)
Overtime Rate ($/hour)
Contract Type
Full-time
Part-time
Contractor
Weekly Number of Hours
Roles and Responsibilities
Remarks
Employee's Signature
Date Signed
-
Month
-
Day
Year
Date
Employer's Signature or Authorized Representative
Date Signed
-
Month
-
Day
Year
Date
Print Form
Submit
Should be Empty: