Pasadena, California

We're so glad you're applying.

This is the Dixon family's sitter application: a few short pages about you, your experience, and what you're comfortable with. Your answers save on your phone as you go, so you can pause anytime.

~5 minto finish

11short pages

1 · Personal

First, the basics.

Full name *

Preferred name Age

Phone * Email

Home address

Drag the pin if it isn't quite right.

2 · Emergency contact

If we ever need to reach someone for you.

Name

Relationship Phone

3 · Experience

Tell us about your childcare experience.

Years of experience Ages you've worked with

Experience with toddlers (ages 2–3)? Yes No

Previous position 1

Family / employer Dates

Child age(s) Reference phone

Previous position 2

Family / employer Dates

Child age(s) Reference phone

4 · Availability

When are you generally free?

Hours per day, like "9-3", "afternoons", or "not available".

Monday Tuesday

Wednesday Thursday

Friday Sat / Sun

5 · Certifications

Any safety training?

CPR certified? Yes No

CPR expiration (if yes)

First Aid certified? Yes No

First Aid expiration (if yes) Other certifications

6 · Logistics

Rate and schedule.

Hourly rate Hours / week desired

Earliest start date

7 · Driving & health

A few just-in-case details.

Valid driver's license? Yes No

Auto insurance? Yes No

Willing to drive our child if ever asked? Yes No

Car make & model Color

License plate Allergies or medical notes we should know

8 · References

Two references, please.

Non-family, please: previous employers, teachers, coaches all work.

Reference 1

Name Phone

Relationship Email

Reference 2

Name Phone

Relationship Email

9 · Day to day

What are you comfortable with?

10 · In your words

Tell us a little about yourself.

A few sentences: who you are, and why this role interests you.

11 · Agreement

Last page: the fine print.

Consent to a background check? Yes No

Photo ID

A quick photo of your driver's license or other ID. *

Confidentiality

I understand the Dixon family works from home, and that their household includes both private family matters and confidential business activity, including unreleased products, inventions, and patent-related work. Anything I see, hear, or learn in or around the household, on any device or document, or in conversation stays private. I will not share, discuss, post about, photograph, or record any of it, and I will treat it as confidential even after I stop working with the family.

I agree to keep everything confidential as described above. * I certify that all information in this application is true and complete. * Type your full name as your signature *

Your signature is recorded with the date and time of submission.