Nickname or Preferred Name

Gender

Whichever you associate with.

Email Address

Citizenship

Where were you born?

Are you a U.S. Citizen?

If not, please explain status of documentation

Would you like to speak to an immigration lawyer?

Availability and Preferences

How many years can you commit to your next position?

If need be, explain:

Are you willing to relocate? If so, where and restrictions to this?

Yearly Salary Requirement:

Hourly Salary Requirement:

Weekly Salary Requirement:

Experience

Are/Were you abused mentally or physically within workplace? If so, explain:

Worked with a High-Profile/Net-Worth Person or Celebrity/Athlete? If so, please explain

DO NOT LIST NAMES only years of employment and applicable details.

Driving children to and from activities?

Working with other staff?

Traveling with a family?

Traveling outside the United States?

Working with multiple children?

If so, how many at one time?

Working with animals? If so, please list below.

What language(s) do you speak?

Please list each and level (novice, intermediate, expert).

High School Diploma?

High School GED?

College Diploma?

If so, list name(s) of school, degree attained and year graduated below:

If you are/were a professional teacher, please list subjects and grades.

Tutoring? If so, list subjects

Are you CPR and First Aid Certified?

If you are/were a professional nurse, please list certifications.

Do you have experience with children that have special needs (emotional, behavioral, academic, or diagnosed)? If so, please describe in detail your experience.

More About You

Do you have a valid passport?

Do you have a valid Driver's License?

Do you own your own car?

Are you a morning person?

What are your top 3 interests/hobbies/activities (example: yoga/piano/soccer, I played in college)

What is your DREAM JOB?? In no more than 4 sentences…

What is your long-term dream? (we are growing fast and want to know your deepest aspirations)

Are you married?

In a serious relationship?

Do you have children? Ages?

Religious commitments? If so, explain:

Do you have any allergies? If so, explain.

Taking any medications? If so, explain.

What was your best memory from our own childhood?

What is your relationship like with your own family GROWING UP?

Are you close with mom and/or dad, siblings, other lifestyle details growing up, and other interesting information you would like to share...

Who are your role models, mentors, and heroes?

Please list TOP 3 References:

Name and Phone Number. We will not contact them without talking to you first.

Do you agree to allow us to run a criminal and federal background check on you?

How did you get referred to Innovative Youth Care?

Candidate Intake Form