Education

Employment History

Experience with Children

Experience with Farm Machinery and Equipment

Experience with Animals

Experience with Office Equipment, Computers

What particular interests do you enjoy sharing with children?

What is your philosophy on raising children, disciplinary measures, and ideals of encouragement?

Ages you are most interested in serving

Personal interests in your off time

Civic groups, boards, or volunteer organizations you serve with

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Have you ever been convicted of a felony?

Yes

Have you ever been convicted of a crime against children or any sexual offense?

Yes

If answered "Yes" to either, please explain

I hereby attest that the above information is true to the best of my knowledge.

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