Nursery Care Provider Application

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Please fill out the application to express your interest in providing nursery care at Polk City UMC.

Email *

Full name *

Please list your experience working with children in a supervisory capacity. *

Please list any education completed related to children, childcare, or church work. Please include date of last CPR/first aid training. *

Please provide a name, phone number, and email for a personal character reference. *

Please provide a name, phone number, and email for a professional reference. *

By checking this box, you acknowledge that this application is simply to express interest in the position. In order to be ultimately considered for the position, consent for a background check and completion of the church's child/youth safety training will be required. These will be provided at a later time. *

I agree

I do not agree and will not be considered further

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