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Nanny Application Form
Name
Last Name
Date of Birth
Email Address
Phone
Address Line 1
Address Line 2
City
State
ZIP Code
How long have you lived at current address?
List all other addresses in the last 7 years
Are you authorized to work in the US?
*
YES
NO
Do you have experience working as a full-time nanny?
*
YES
NO
Which position are you interested in applying for?
*
Required
Full-time Nanny
Part-time Nanny
Seasonal Care
Special Event Care
Highest level of education completed
*
Highschool or GED equivalent
Some college
College Degree
List school names, city, state, graduation date, and major/minor
Are you currently certified in infant and CPR?
*
YES
NO
Are you currently certified in First Aid?
*
YES
NO
Why are you currently looking for a job?
Have you ever been fired from a child care job?
*
YES
NO
If yes, please explain.
Do you have clean criminal and driving records?
*
YES
NO
If no, please explain.
Do you have a valid driver's license and full coverage vehicle insurance?
*
YES
NO
If no, please explain.
Other than english, which languages do you speak?
Available Start Date
Days/Hours available to work
Are you fully capable of playing with/carrying children up to 40 lbs?
*
YES
NO
Is there an age group you prefer to work with?
Is there an age group you are NOT willing to work with?
Do you have experience with infants?
*
YES
NO
If yes, please provide detail of your experience.
Please provide at least 3 non-familial references of child care experience or most relevant employment .
Reference 2
Reference 3
Reference 4
Reference 5
Which job duties are you willing to complete (Check all that apply)
*
Required
Tidy up after kids
Tidy up after entire family
Make bed for child(ren)
Make bed for parents
Laundry for child(ren)
Laundry for entire family
Wash Dishes/Empty dishwasher
Errands for child(ren)
Errands for entire family
Cooking for child(ren)
Cooking for family
Travel with family
Carpooling
Playdates
Occasional babysitting (date night)
Occasional overnight
Vacuum/mop
Organize
Clean bathrooms
Pet care
Upload resume
Upload resume
Upload supported file (Max 15MB)
Uploade photo ID
Upload supported file (Max 15MB)
Submit
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