Babysitter Application

We are in need for a babysitter to watch Zoie-Lynne at our house 1-3 nights a month.  Once in awhile we might need a full day when our daycare is closed.

Babysitting would be done at our home.  Must be willing to play, take walks & go to the park.

This will pay between $10-15 an hour depending on experience.

Please fill out the application below, if you do have a resume please attach.

If you have any questions or would like to contact me, please text me @ 717.668.3357.

Personal Information

First Name*:

Last Name*:



Do you text?:YesNoSometimes

Year of Birth*:




Do you have children*:YesNoOn The Way

Will you be bringing your children:YesNoSometimes

Marital Status*:SingleDatingDomestic PartnershipWidowed

Will you be bringing your significant other:YesNoSometimes


Have you been arrested?YesNo

Do you have any drug related issues?YesNo

Would you be willing to supply a background check?YesNo


Highest level of education:

Are you currently enrolled in college?YesNo

Any certifications:YesNo

If yes, what certifications?

Are you CPR certified for baby/children?YesNoBecoming


Are you currently employed?YesNoIn-Between

Do you work evenings?YesNoSometimes

How much notice do you need to babysit?


Do you have your own vehicle?YesNo

Do you have insurance for the vehicle?YesNo

About Yourself


What do you do in your spare time?

A little more about you:


Please provide at least 2 references

Full Name:

Phone Number

Full Name:

Phone Number


If you have a resume please attached