Kiddie Care
Emergency Baby Sitting Services
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Sitters Registration Form
Basic Information
First name :
Surname
*
:
Date of birth :
Gender :
Male
Female
Email
*
:
Primary number :
Alternate number :
Permanent address :
City :
State :
Zip code :
Employment Specification
Days available:
Hours available:
Rate:
Area of coverage:
Ages comfortable with:
0-1
1-3
3-10
10+
Maximum number of children:
Do you drive?
Do you own your own transportation?
Are you willing to travel?
About You
Education level:
Major:
Degree completion date:
Do you smoke?
Do you have allergies?
Capabilities:
Cooking
Driving
Laundry
Light housekeeping
Run Errands
Skill certification:
Behavioral Issues
Special Needs
CPR
First Aid
Hobbies/Interest:
Employment Criteria
Do you have a police record?
Yes
No
Will you consent to a Drug Test?
Yes
No
Are you legally allowed to work in the US?
Yes
No
*
Child experience:
*
Are you human?
:
2 + 3 =
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