First Name
M.I.
Last Name
Cell Phone
Home Phone
Other Phone
E-mail
Street Address
City
State
Zip Code
Are you a US citizen?
Yes No
If no, are you authorized to work in the US?
Yes No
Have you ever worked for Resort Sitters?
Yes No
When?
Are you 21 years old or older?
Yes No
Are you CPR Certified?
Yes No
Are you looking for PT or FT Work?
PT FT
EMPLOYMENT
EDUCATION
High School
Dates Attended
Did you graduate?
Degree
Yes No
College
Dates Attended
Did you graduate?
Degree
Yes No
Other
Dates Attended
Did you graduate?
Degree
Yes No
REFERENCES
Please list child care references
Full Name
Relationship
Company
Phone
Full Name
Relationship
Company
Phone
Full Name
Relationship
Company
Phone
GENERAL
Subjects of special study or research work:
Babysitting related skills:
How long will you be in the area?
List any foreign languages you speak:
Do you have a car?
Yes No
Do you have access to the internet?
Yes No
Would you be able to take children swimming?
Yes No
Do you have hobbies that you would be able to share with children?
What ages do you prefer to babysit?
Do you have experience with special needs children?
Yes No
List all your childcare experience:
Describe your availability.
I certify that my answers are true and complete to the best of my knowledge.
Name
Date