Employment Opportunities

Independent Contractor's Verification Application
Super Sitters, Inc.
4002 Bounce Drive, Orlando, FL 32812
Tel: 407-382-2558

Personal Information

Please leave this field empty.

Type of position desired:
 FT Nanny PT Nanny - less than 26 hours On-Call

Are you currently employed?
 Yes - I am currently employed No, I am not currently employed
May we inquire of your present employer?

High School


Trade, Business, or Correspondence School

Do you speak a second language? If so, please list below.

Can you swim?
Are you comfortable with pets?

Former Employers (most recent first)
Employer 1

May we contact employer?

Employer 2

May we contact employer?

Employer 3

May we contact employer?

Closest Relative

Personal References
First Reference

Second Reference

Third Reference

Please write a brief auto-biography to help families learn more about you and why you should be considered for this position

Please describe how you would handle the following hypothetical situations.
A child that has difficulty waking up for school

You find the child playing with a toxic chemical or an empty medication bottle

The children are fighting over sharing a toy

A child who won't eat his/her meal

What kind of indoor activities would you use to occupy a child?

A colicky baby

An insubordinate child

Have you ever been convicted of a crime?
 Yes, I have been convicted of a crime. No, I have not been convicted of a crime.
If yes, please explain:

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information.

Electronic Signature - this is your legal signature and confirms that you have read and agree to the above Authorization:
Name: Date: