Care Provider Application

Upload Your Best Smile For Your Profile *

Preferably from the shoulders up to ensure professionalism (no heavy filters please)

Legal First name *

Please provide your first name.

Legal Middle Name *

Legal Last name *

Please provide your last name.

Email *

Please provide your email address.

Phone *

Please provide your phone number.

Zip / Postal Code *

Job position *

Please confirm the position we are onboarding for:

Emergency Contact Name & # *

Only for emergencies

Care Provider Bio *

Family’s first impression, share childcare experience, skills, what makes you a good candidate? Hobbies? Pets? Childcare Experience?

Do you have a valid Driver's License & own a vehicle? *

What is your desired pay range for this position? *

Do you have a working phone with internet access? *

Are you legally authorized to work in the USA? *

What is your availability? *

Please tell us your preferred week schedule, including any date-night/evening availability.

Please Upload your Resume *

Upload A Driver's License *

We must ensure you have a valid DL in the event of an urgent transport, etc.

Upload CPR/First Aid Certification/Card *

If you do not yet have this, please schedule with a local class to add as a resume booster and ensure child safety.

Or a date you are scheduled for the class!

Do you have experience working with children on the Autism Spectrum? *

Employment History (we REQUIRE email addresses for your references *

Add your work history below. Click + to add more entries. We must receive a minimum of 3

Job #1

Employer Name

Your Position

Start Date

End Date

Employer Phone

Employer Email

City

State

Job Description

I grant Mary’s Child & Pet Care, LLC consent to contact my references & run a background check during the vetting process. *

Please add email addresses in the job history section when possible!

Yes

I understand MCPC abides by safety & professional standards to maintain a reputable brand and ensure the safety and welfare of children. *

Please confirm you understand and will attend the required educational trainings as needed. This includes renewing CPR/FA when close to expire dates!

How did you hear about us? *

We’d love to thank whomever referred you!

Background Check results are collected prior to moving forward with an interview to ensure it meets our requirements due to the nature of working with children.

Reference Name, Email & #

If you have not yet added 3 references under employment section, please add one here.

Do you have infant care experience? *

Bottle feeding, supporting infant’s neck, proper holding, burping, etc.

Please explain

Give examples on infant experience

COVID Vaccinated? *

Do you consent for us to share this info with our families?

We will add a vaccination badge to your profile!

High School & Graduation Year *

GED or Diploma?

College Name, Graduation Year (OR In Progress):

Write "current" or "in progress" if you haven't earned the degree.

Can you perform the essential functions of the job for which you are applying either with or without reasonable accommodation? *

You must be able to bend, lift/carry children, and get on their level during play periods (as-needed).

Briefly explain any tickets or accidents: *

Social Security Number *

We need this during tax season if earned income is greater than $600 for the year

Have you ever been convicted of a crime? *