Sanctuary Child Care Worker Application
All information will be kept confidential
Date *
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Full Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Birth Date *
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Why do you want to work with children at Sanctuary Faith Community? *
Your answer
Please list any talents, training, education or other factors that may help you to work with children:
Your answer
List any organizations, other than ours, in which you were involved in working with children. Include the organization type, description of your involvement, and approximate ages of children
Your answer
Do you have any medical training or are you CPR certified? (Please explain) *
Your answer
The safety of children is a primary objective for us. All information is held strictly confidential. Answering yes to any of the questions below may not necessarily preclude your involvement. Thank you for your understanding. Before employment, you must submit the clearances required by Pennsylvania law and take a mandatory report training online course. We will reimburse you for any cost.
Have you ever been hospitalized or treated for alcohol or substance abuse? *
Have you ever been accused of, arrested for, convicted of, or are you currently under investigation for a criminal offense excluding minor traffic violations? *
Have you ever been accused of, arrested for, convicted of, or are you currently under investigation for any sexually related crimes? *
Have you ever been accused of, arrested for, convicted of, or are you currently under investigation for any abuse related crimes? *
Are there any circumstances involving your lifestyle or your background that would call into question your ability to work with children? *
If you answered yes to any of the above questions please explain:
Your answer
References
List two references (not relatives). Please give full names, telephone numbers, and their relationship to you.
Your answer
Release Statement The information contained in this application is correct to the best of my knowledge. I authorize any references or organizations listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for working with children or youth. I release all such references from liability for any damages or claims that may result from furnishing such evaluations to you. I understand that any omission of material fact on this application may be grounds for rejection of this application. Please provide an online signature by typing your name and dating below. *
Your answer
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