Please complete the information below.


Email address:

Phone number:

Is the number above a cell, work or home number? Cell Work Home

You must be 16 years or older to apply for this position. Are you at least 16 years of age? Yes No

We are seeking coverage for 3 to 5 weekday morning shifts per week. To be a candidate for this position, you would need to be able to work at least 3 morning shifts per week. Are you able to work at least 3 weekday mornings per week?
Yes No

Please check all MORNING shifts you are able to work below.
Monday, 9 - 11:30 am
Tuesday, 9 - 11:30 am
Wednesday, 9 - 11:30 am
Thursday, 9 - 11:30 am
Friday, 9 - 11:30 am
Saturday, 9 - 11:30 am

Please check all EVENING shifts you are able to work below.
Monday, 6 - 8 PM
Tuesday, 6 - 8 PM
Wednesday, 6 - 8 PM
Thursday, 6 - 8 PM

On a scale of 1 - 5, How much do you enjoy working with kids?
1 - Not at all
2 - Mild enjoyment
3 - Moderate enjoyment
4 - High enjoyment
5 - Very high enjoyment

How comfortable do you feel helping kids have fun, be kind and respectful to each other?
1 - Not at all
2 - Mildly comfortable
3 - Moderately comfortable
4 - Very comfortable
5 - Extremely comfortable

Tell us a little about yourself, your experience with kids and why you'd make a great UU "Playcare Pal."

Level of education completed.
Some High School
High School Graduate/GED
Some College
College Graduate

If you are currently employed, please provide the name of your employer below.


Dates of employment:

Job title and brief description of duties:

Company Name

Location (city and state)

Telephone number

Dates of employment

Job Title and brief description of duties.

Name of supervisor

Tobacco, Alcohol and Drugs Policy
Ultimate U is a wellness and fitness company committed to bettering the health of those we serve. The use of tobacco, abuse of alcohol, involvement with illegal drugs or the use of legal drugs for purposes other than that for which they were prescribed is incompatible with our mission and core values. In the past, have you been disciplined for violating company policies forbidding the use of drugs, alcohol or tobacco products or convicted of a crime related to the use or illegal distribution of alcohol or drugs?
Yes No

Do you have any additional comments or questions?
Thank you for your interest in this position.
* Indicates field is required.