Employment Application
View our current career opportunities.

Contact Information
First Name *
Middle *
Last Name *
Address Line 1 *
Address Line 2 *
City *
State/Province *
Postal Code *
Are you 18 years of age or over?
Are you interested in Full Time or Part Time Hours?
Enter N/A if this does not apply to you.
Have you ever been arrested, convicted of a crime, or have a current criminal charge pending?



Would you be willing to continue your education by enrolling in certain courses or training programs that may be recommended?
No file selected
No file selected

Work Experience

Not required if this information is included in your attached resume. 

May we contact?
May we contact?
May we contact:
Have you ever been discharged or requested to resign from any position?

Professional References

Personal References


The information furnished in this application is accurate and complete, and I understand that false or misleading information may result in a refusal to hire or be cause for discharge.

In accordance with State and Federal Laws, Children’s Respite Care Center (CRCC) is required to complete a criminal background check.  I understand that my employment at CRCC is conditional upon receiving a favorable response.

I hereby authorize release of any and all information regarding my employment experience to assist in determining my suitability for employment.

Should I be employed by Children's Respite Care Center, I agree, if requested, to undergo and satisfactorily pass a medical examination prior to employment.

No written or unwritten policy or practice of CRCC creates, or is intended to create, an express or implied contract, covenant, promise, or representation between CRCC and the employee.  Employment with CRCC may be terminated at any time with or without cause or notice by either CRCC or by the employee.

Entering your name below acts as an electronic signature.