Interested in an ABC Opening?

We are excited about your interest in the opening with the family you were contacted about. To facilitate your thoughts and feelings about this opportunity, we kindly request that you provide us with all the details illustrating why you believe you are the ideal candidate for the family. Your input will be instrumental in our discussion about you with the family considering your employment. If you have any additional comments for your counselor, to be shared before she communicates with the family, please feel free to include them in the Additional Comments section at the bottom of this form.

We highly encourage you to provide us with as many details as possible regarding your interest. The more information we have, the better we can effectively communicate your specific feelings, questions, and enthusiasm about the position to the family.

Thank you! We appreciate your time in reviewing our profile, and we assure you that we will be in contact with you very soon regarding the feedback we receive from the family.

*	Indicates Required Field
Your last name:*
Your first name:*
Your contact number:*
Your e-mail:*
Family ID number:*
Date You Can Start:*	(MM/DD/YYYY)
Best Time to Call You:*	(HH:MM)
Position city and state:
Your approx. Drive time to family's home:*	(minutes)
Are you comfortable with this drive?*	Yes No
Time spent with family:*	(X hours X minutes)
Did you meet both parents?*	Yes No
Who did you meet with?
How much did you like the family?*
If offered this position, how soon would you be able to start?*	(MM/DD/YYYY)
Were you able to interact with the children?*	Yes No
If so, how well did the children connect with you?
Did you feel comfortable around the family?*	Yes No
If I worked for this family I feel we would...
Did the family discuss having a second interview?*	Yes No
Did the family discuss a salary or hourly wage with you?*	Yes No
If so, how much was discussed?
Did the family mention a start date?*	Yes No
If so, when?	(MM/DD/YYYY)
Did the family discuss duties they would expect you to do?*	Yes No
If so, what types of things were discussed?
Additional comments: