Family Application

    Parents Names
    Both parents contact numbers
    Nationalities
    Email Address
    Occupations
    Employers
    Home Address
    City
    State
    Zip Code
    Languages spoken at home

    CHILD INFORMATION


    Number of Children
    Names
    Ages
    Gender
    Dates of Birth
    Child’s Interest and Activities
    Are you currently expecting? YesNo

    Due Date

    JOB INFORMATION


    Starting Date
    Job Title
    What hours do you want the Nanny to work?

    Full Time ( 30 hrs or more / wk)Part Time(15-29 hrs/wk)
    Monday
    Tuesday
    Wednesday
    Thursday
    Friday
    Saturday
    Sunday
    Total amount of guaranteed hours per week
    Do you require a COVID-19 Vaccinated Nanny and/or other vaccinations?
    Will weekends be required? YesNo
    If yes, how often?

    Will evenings be required? YesNo
    If yes, how often?

    Would you consider a Nanny who wanted to bring her own child to work? YesNo
    If yes, what age range?

    Hourly range (based on duties, experience, number and age of children and education of Nanny).

    Benefits to be provided
    Medical Insurance
    Paid sick day
    Paid Holidays
    Paid Vacation

    Are you prepared to pay Nanny´s Tax?
    Would you be working with a Tax & Payroll Company?
    Describe your home situation (size, formal, casual, condo, house, etc.).

    NANNY DUTIES


    Please check all that apply:
    Run Errands, shopping?
    Homework / Tutor Children
    CookingChildrenFamily
    LaundryChildrenFamily
    Drive ChildrenOwn CarFamily Car
    TravelWeekendExtended
    Care for PetsYesNo
    Swim with Children
    Further Explanations
    Would light house cleaning be required? Please explain
    Do you hire other housekeeping help? YesNo
    If yes, how often?

    Will driving be an essential duty? YesNo

    Is the car available for the Nanny´s personal use? YesNo

    ADDITIONAL INFORMATION


    Describe your family to the candidates.
    Do either parent work in the home? YesNo
    If yes, how often?

    Are there any specific needs? (physical, mental, or emotional) that your Nanny should know about.
    Explain your philosophy about child discipline.
    Have you had a Nanny before? If yes, what has been you experience?
    Give a description of your ideal Nanny.
    When would you like to schedule an appointment to chat with us? Day and time
    How did you hear about our Agency? Are you currently working with another Agency?
    Please give us additional information that would be helpful for us to know.
    Comments.