Sitters, LLC

Independent Contractor

Please fill out this form completely, and then click on the "Submit" button to send the information to us. We will review your submission and contact you as necessary.

Applicant Information

Position Applied For:
Adult
Children
Hospital
Church
Group
Cleaning
Yes
No
Yes
No
Yes
No
Yes
No
What days are you available
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What hours are you available?
Areas of Experience
Elder Care
Child Care
Cleaning
Are you afraid of Animals?
No Animal Fears
All Dogs
Only Large Dogs
Cats
non Domestic Animals

Education

High School
Did you graduate?
College
Did you graduate?

References

Please list three personal references. NO RELATIVES

Reference 1
Reference 2
Reference 3

Previous Employment

Employer 1
May we contact your previous supervisor for a reference
Employer 2
May we contact your previous supervisor for a reference
Employer 3
May we contact your previous supervisor for a reference

Special Skills & Certifications

Disclaimer and Certification

By clicking on the "Submit" button, I certify that my answers are true and complete to the best of my knowledge. Further, I hereby authorize the agency to obtain any information related to past employment, background check, medical records, etc. for the purpose of application evaluation. If this application leads to a contract, I understand that false or misleading information in my application or interview may result in my release.

   

Please print the attached form and fax it to our office.

Cindy Yelverton, Owner

Jackson, MS
P.O. Box 12597
Jackson, MS 39236
601-981-3661

Oxford, MS
662-259-2401
or 601-291-6555

Care is our calling

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