US and Canadian provider registration Form
Fill out the form below to sign up for your FREE Sitter Account
. You will be able to edit your profile information at any time once your account is approved.
NOTE: You must be 18 years or older to be eligible to apply.
Your Registration Information
Name
*
Address 1
*
Address 2
City
*
State/Province
*
Alabama
Alaska
Alberta
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Postal Code
*
Country
United States
Canada
Neighborhood
School
Phone 1
*
Phone 2
Cell Phone/Pager
Email
*
Confirm Email
*
Birth Date
You must be at least 18.
*
(mm/dd/yyyy)
Years Experience
*
0
1
2
3
4
5+
Education
Availability.
Check all that apply.
*
Time/Day
SU
MO
TU
WE
TH
FR
SA
Morning
Afternoon
Evening
Overnight
Your Rate $
*
per
Hour
Day
Week
Transportation
I have a valid driver’s license.
I have reliable transportation available to me.
I require the family to provide my transportation to and from their home.
I am willing to transport children to and from events, activities, school, or appointments.
I am willing to run errands, shop for, or make deliveries as needed.
Please describe other transportation issues.
(Please provide ample details, no email addresses, resumes, or phone numbers in this area please)
Services
Babysitter
Full Time Nanny
Daycare Service
House Sitter
Pet Sitter
Senior care/assisted living
Spanish Speaking
French Speaking
Tutoring
Experience with special needs
I have worked with the following age groups.
Infant
Toddler
Preschool
School-age
Preteen
Teenage
Message to families: Express your reasons for wanting to be a provider, your uniqueness and experience.
*
(Please provide ample details, no email addresses, resumes, or phone numbers in this area please)
I am prepared to perform the following tasks.
Grocery shopping
Emptying the trash
Wash laundry
Plan and cook family dinners
Light housekeeping
Feed and care for pets
I have completed the following certifications.
Certificate from babysitting program
Child development coursework
Certificate from nanny program
CPR certified (current)
State/County Daycare license (current)
First Aid Training (current)
EMT (current)
LVN/LPN License
RN License
Teacher License
Teacher Aide
Special Education Certification
all/
none
Other Certifications
(Please provide ample details, no email addresses, resumes, or phone numbers in this area please)
References
(please obtain approval from your references before including their contact information)
Describe your own childhood and yourself.
*
(Please provide ample details, no email addresses, resumes, or phone numbers in this area please)
Please explain what dependability and reliability mean to you.
*
(Please provide ample details, no email addresses, resumes, or phone numbers in this area please)
How do you discipline children?
*
(Please provide ample details, no email addresses, resumes, or phone numbers in this area please)
What types of educational activities do you routinely engage in with the children?
*
(Please provide ample details, no email addresses, resumes, or phone numbers in this area please)
Mailing List
By checking this box you give 4Sitters permission to send you information and new job postings via email.
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*
Yes. I have read and agree to the
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