STEP 1 * Required Location - St Louis Name * * First Last Address * Street Address Address Line 2 * Please choose a state AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VI VT WA WI WV WY * * City State Zip Code Contact Information Mobile Phone (required) Email * (this is your log in ID)* Mobile phone carrier/provider Select One Alltel AT&T Boost Mobile Cellcom Cricket Metro PCS Sprint T-Mobile US Cellular Verizon Virgin Mobile * Phone Number Work Phone Personal Information Birth date Gender Select Month January February March April May June July August September October November December Select Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935 * Select Gender Female Male * What is your marital status? Do you have any children of your own? Select Marital Status Single Married Separated Divorced Widowed * Yes No* Do you smoke? Do you have any pets? Yes No* Yes No Do you have, or have you previously had any allergies? Please list them below. Do you have any other health issues? Please list any below. What are the best times to contact you regarding this application? Please list optimal contact times as well as any times you will be unavailable.* Transportation Do you have a car to get to work? Are you willing to transport children in your vehicle? Yes No* Yes No* Please list year, make, model of your current vehicle.* Education What high school did you attend? What year did you graduate? Are you currently enrolled in or have you completed any part of college? If you are currently attending college, are you full or part-time? Select one I have never attended college I am currently a freshman I have completed my freshman year I have completed my sophomore year I have completed my junior year I have completed my senior year I have a bachelors degree I have a masters degree I have a doctorate Select one I have never attended or am not currently attending Part-time Full-time I completed college If you attended college, what school did you attend? What is/was your field of study? Are you currently First Aid certified? Are you currently CPR certified? Yes No* Yes No* Do you speak any languages other than English? If you speak language(s) other than English, which ones? Yes No Background How long have you been living in the state of Missouri? Have you had a background check completed in the last 3 months? * Yes No* Have you ever been arrested? If so, please provide details below.* Have you ever been convicted of a felony or misdemeanor? If so, please provide details below.* Have you ever been convicted of Driving Under the Influence of Drugs or Alcohol (DUI) or any other drug / alcohol related activity? Including underage drinking. If so, please provide details below.* Miscellaneous How did you hear about us?* Which Service Are You Applying For? Child Sitting Tutoring *one of the above is required Other No infants No cats No dogs Password Password *