Interested in an ABC Opening?

Please take a moment to provide us with all the details on why you believe you are the perfect fit for the family you were contacted about. This will help us understand your thoughts and feelings and expedite the process. We will use your input to have a further discussion about your qualifications with the family who is considering hiring you. If you have any additional comments you would like to share with your counselor before they speak with the family, please feel free to include them in the Additional Comments section at the bottom of this form.

The level of elaboration we can provide to the family about your specific feelings, questions, and enthusiasm regarding the position is directly proportional to the amount of detail you share about your interest!

Thank you for submitting your profile! We appreciate your interest in our services. Rest assured that we will review your profile thoroughly and consider your suitability for our program. Once the family has had the chance to review your profile, we will be in touch with you very soon to provide feedback. We value your patience and look forward to speaking with you again soon. Thank you!

*	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: