Bend Snappy Sitters, LLC - Baby Sitter Application

Bend Snappy Sitters, LLC - A Central Oregon Childcare Referral Service


Full Name
Home Address
Phone Numbers
E-mail Address
Emergency Contact Name and Phone Number
Please provide information for the hours which you are available for work. Please be specific as to what hours you are available to work
If you are a student, what school do you attend?
Are you CPR or First Aid Certified?
Are you legally able to work in the U.S.?
Do you have reliable transportation?
Do you have a valid drivers license and car insurance?
If so, please enter the license number and state it was issued
Social Security Number (to conduct background check)
Date of Birth
Are you allergic to any pets?
What kind of animals would prevent you from taking a job?
Do you have any medical conditions that would impact how you perform the job?
What do you like most about working with children?
Education History: Please list most current school/institution attended first
School Name
City, State
Graduate?
Years attended
School Name
City, State
Graduate?
Years Attended
School Name
City, State
Graduate?
Years Attended
Have you participated in any volunteer work that you would like us to know about?
Employment History
May we contact your current employer?
Employer
Supervisor's Name
Phone Number
Start Date
End Date
Reason for leaving
Employer
Supervisor's Name
Phone Number
Start Date
End Date
Reason for leaving
Employer
Supervisor's Name
Phone Number
Start Date
End Date
Reason for leaving
Please explain your child care experience and training
References
Name
Company
Phone Number
Name
Company
Phone Number
Name
Company
Phone Number
Please provide at least two personal references that are not related to you below
Name
Phone Number
Relationship
Name
Phone Number
Relationship
Name
Phone Number
Relationship
Signature
By checking this box, you agree that the information provided here is accurate to the best of your knowledge.

To learn more, contact Bend Snappy Sitters, LLC today at 541-419-0997