Babysitter Application Form:
Please fill out this form if you were hoping to join our Babysitting Team.
Your Full Name:
Your Email Address:
Confirm Your Email Address:
Contact Cellphone Number:
Landline Number (Leave blank if not applicable):
Your current Age is?:
Aged 18 years OR older
Aged 17 years
Other (please explain below):
Please choose the most accurate option. Note: If you are younger than 17 years, we will not be able to process your application any further at this time, but we will retain it on file.
Current Level of Valid Car Drivers Licence Held:
Full plus additional classes (E.G. Passenger)
Please choose the most appropriate answer.
Do you have access to your own vehicle (suitable for transporting children as in current WOF and Rego, NOTE: car seats would be provided by families if required):
Other Situation...(please explain below):
Do you have a current First Aid Certificate/Are you willing to get one?
No, and No I don't want to get one
No, but Yes I'm willing to get one
I did one in the past but it is no longer current
Yes and it expires on... (please enter expiry date below):
First Aid Certificates are valid for 2 years from completion date.
Do you have any criminal convictions?
Yes (but they do not require explanation in realation to the Vulnerable Children's Act).
Yes but let me explain...
If you have any criminal convictions we will need you to explain these to us, to enable us to assess how these impact your ability to work with children as part of legislation relating to the Vulnerable Children's Act. Please provide explanation in the space above.
Have you completed a police check for any other employment/Volunteer agency within the last 12 months?
Yes, I think I would be able to get a copy
Yes, but I do not think I would be able to get a copy
No, but I'm willing to get one
No and No I don't want to get one
Other (Please explain below)...
Will you be staying in Dunedin 1 year minimum or longer?
Other (Please explain below)...
Please describe your circumstances above if necessary.
Do you usually stay in Dunedin over the Summer Period (excluding less than any 3 weeks around the statutory holidays)?
No I travel back to....
Please type the city you usually travel to above, or your other circumstances (if applicable).
Are you currently permanently living in Dunedin?
Yes I am already here.
Not right at this moment, I am arriving on...(please enter date below):
I would be available to start work from...
What kind/amount of work are you ideally looking for?
Casual (as/when suits you).
Casual (4-10 hours per week)
Other (Please Explain in more detail):
Tick all that apply to your current circumstances (we understand these may change over time).
Tell us about...What is your current work/study status? What is your general availability for work in the day time, night time, and in the weekends?:
Do you have one or more referees that are from a context working with children? (Our Policy is to contact 2 referees, 1 minimum must be in a context working with children but preferably both are).
No but I do have...
Please use the space above if required to explain how your referees might still be suitable to meet our policy.
REFEREE DETAILS (fill in all spaces use N/A if not applicable):... We require to be able to contact 2 referees (all must be from a working context, 1 minimum must be in a context working with children but preferably both are, we also ask for a back up referee whom we will only contact if either of the others are unreachable, please let your referees know to expect our call).
Preferred Contact Phone Number:
Email Address (if from Overseas):
Relationship to you:
Have you contacted them in advance?:
Preferred Referee 1:
Preferred Referee 2:
Back-Up Referee 3:
Please outline in the Cover Letter how your past experience meets the qualities we are looking for in the the Job description provided.
CV (Curriculum Vitae):
Please upload your up-to-date CV here.
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