Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have at least 3 years experience working with toddlers in someones home? *

Yes

No

Do you have the legal right to work in the U.S.A.? *

Yes

No

Please select ALL of the groups you have experience with: *

Infants (0-1yr)

Toddlers (2-4yrs)

Grade school (5-12yrs)

Special Needs

Autism

Can you commit to at least 4 months in this position? *

Yes

No

What is your highest level of education? *

High School

Some College

Associate's Degree

Bachelor's Degree

Master's Degree

PhD

What specific skills do you posses? (select all that apply): *

I can swim.

I am crafty and/or have a strong interest in art.

I have experience teaching (classroom TA, tutor, etc.).

I have worked as a camp counselor.

I have specific sports skills (coaching experience play/played a competitive sport).

I have cooking experience and/or cook regularly at home .

I have an Education or Early Childhood Ed. background.

I have experience playing an instrument.

I have a Nutrition or Health Promotion background.

I love outdoor adventures.

Are you CPR/ First Aid certified? *

this is required of all NHN Team Members

Yes

In Progress/ Willing to Complete

Do you have an insured car to drive to work? *

Yes

No

I do not have a car. I will commute by public transportation.

How can we contact you? *

Text

Call

Email

Any

I agree that everything above is accurate and honest: *

I agree