Join the Team | Cheyenne, WY

Application

Application

Name*

First

Last

Phone*

Email*

Address*

Street Address

Address Line 2

City

State / Province

ZIP / Postal Code

Country

Position Sought:*

Date Available to Start Working:*

Are you 18 years old or older?*

Yes

No

Are you currently employed?*

Yes

No

Do you own (or have access to) a vehicle with current registration and full insurance coverage, that is available for you to transport clients with during your shift?*

Yes

No

Is there any reason why you would not pass a DFS/ DCI background check?*

Yes

No

Are you flexible regarding the hours you are available to work?*

Yes

No

Can you work any shift/ hours needed?*

Yes

No

Are you currently certified in CPR/ First Aid?*

Yes

No

Are you currently certified in CPI/ MANDT?*

Yes

No

Is the any reason why you would not be physically able to lift, carry, or assist in carrying a child or reasonably sized adult?*

Yes

No

Education

Education

Did you graduate from high school?*

Yes

No

High School:

Did you earn a GED?*

Yes

No

Have you attended college?*

Yes

No

College/ University:

Have you earned a degree?*

Yes

No

Degree

Do you have any other education/ certifications?*

Yes

No

Please List:

Current/Previous Employment

Current/Previous Employment

Company

Location

Name of Supervisor

Job Title

Employed from (Month/Year)

To: (Month/Year)

Responsibilities/Tasks Performed

Previous Employment #2

Previous Employment #2

Company

Location

Name of Supervisor

Job Title

Employed from (Month/Year)

To: (Month/Year)

Responsibilities/Tasks Performed

Previous Employment #3

Previous Employment #3

Company

Location

Name of Supervisor

Job Title

Employed from (Month/Year)

To: (Month/Year)

Responsibilities/Tasks Performed

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