Bucks County Child Care Consultants

2157 Mill Valley Lane

Quakertown, PA  18951

www.childcaretrainingonline.com

Application for Childcare Positions

Name: ___________________________________________

Address: _________________________________________

City, State, Zip; ____________________________________

Phone: ______________________ Cell: _________________

Email address: _____________________________________

How did you hear about this opportunity? _____________________

What kind of positions are you interested in? (Check all that apply)

Full time ________ Part time _________ Substitute___________

Center ______ Family Child Care________ Nanny/Babysitting ____

When are you available for work? Start date_____________________

Days and times available:

 Monday_____________________________________

              Tuesday: _____________________________________

              Wednesday: ___________________________________

              Thursday; ____________________________________

              Friday: ______________________________________

              Saturday: ____________________________________

              Sunday: _____________________________________

What locations are you willing to work in?

Lower Bucks______________________________________ 

Central Bucks_____________________________________

Upper Bucks______________________________________ 

Lower Montgomery County_____________________________

Central Montgomery County ___________________________

Upper Montgomery County ____________________________

Are you currently employed?  Yes___ No_____

If yes, where? _________________________________________

May we contact your current employer? ____________________

Name and phone number: _______________________________

What experience have you had in the childcare field? (List all experience including volunteer) ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What certifications, clearances and trainings have you had in the childcare field? Please bring a copy to the interview

CBK/PDR____________ FBI Screening________

Act 33___________ Act 34__________

First Aid/CPR_____________ Fire Safety___________________

Any other training that would apply? ________________________________________________________________________________________________________

Please attach resume and three references