Families Together

Do you have a vehicle that you can use in your work? Yes No

Do you have current and valid vehicle insurance? Yes No

Please list any tickets, reckless driving charges, traffic violations, DUI's,
or any other vehicle violations that may show up on a DMV check:

Have you ever been charged with, or arrested for a felony or misdemeanor? Yes No

Have you ever been convicted of a felony or misdemeanor? Yes No

Have you ever been investigated for child abuse or neglect? Yes No

Has there ever been a case of child abuse or neglect substantiated against you? Yes No

May we contact your current supervisor? Yes No

If you have a resume in Microsoft Word document format please submit it:

By checking this box,
you authorize FTI to check criminal,
DMV and reference checks as appropriate