REQUEST FOR CHILD CARE SERVICES

All Fields are Required for Posting.

First Name:

Last Name:

Address:

Daytime Phone:

Nighttime Phone:

E-mail Address:

Hours Needed:

Wage/Salary: $

Starting Date:

Description of Duties:

Requirements:

Non-Smoker: Yes No

Own Transportation : Yes No

Please furnish preferably two (2) references; one is sufficient if you are new to the area. Whenever possible, we prefer that the references are Salve Regina faculty, staff, or graduate.

Name: Phone:

Name: Phone:

It is understood and agreed that Salve Regina University makes this request for services available to interested students

.Any arrangements are made solely by intersted parties and students. Therefore, Salve Regina University has no obligation other than posting the request for services. The University makes no commitment beyond what is stated and does not assume any liability with respect to any services provided.

Posting will be for 1 month unless otherwise requested.

I have read and understand the information on this form.