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Name(Required)
Address(Required)
MM slash DD slash YYYY
Safety & Security(Required)
The safety and security of children is a primary objective for us. All information is held strictly confidential. Answering yes to any of the questions below may not necessarily preclude your involvement. Thank you for your understanding.
Have you ever been hospitalized or treated for alcohol or substance abuse?(Required)
Have you ever been accused of, arrested for, convicted of, or are you currently under investigation for a criminal offense excluding minor traffic violations?(Required)
Have you ever been accused of, arrested for, convicted of, or are you currently under investigation for any sexually related crimes?(Required)
Have you ever been accused of, arrested for, convicted of, or are you currently under investigation for any abuse related crimes?(Required)
Are there any circumstances involving your lifestyle or your background that would call into question your ability to work with children?(Required)
Reference Request Form(Required)
List two personal references (not former employers or relatives). Please give complete mailing addresses and telephone numbers. First & Last Name Street Address City, State Zip Area Code & Telephone
Consent(Required)
The information contained in this application is correct to the best of my knowledge. I authorize any references or organizations listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for working with children or youth. I release all such references from liability for any damages or claims that may result from furnishing such evaluations to you. I understand that any omission of material fact on this application may be grounds for rejection of this application.

KCARE is a 501(c)(3) organization
(Tax ID Number 87-4623228)

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KCARE is a 501(c)(3) organization
(Tax ID Number 87-4623228)

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  • (773)369-5515
  • [email protected]

Quick Links

  • Home
  • What We Do
  • Get Involved
  • Donate
  • Home
  • What We Do
  • Get Involved
  • Donate
  • Volunteer

Support

  • Terms and Conditions
  • Privacy Policy
  • FAQs
  • Contact Us
  • Terms and Conditions
  • Privacy Policy
  • FAQs
  • Contact Us