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Nanny Application
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Name *
E-mail Address *
  I have read the application policies (click on link above to read)
Date available for employment *
Type of position *
Salary desired *
How many days of week will you work? *
Will you relocate? *
Where to? *
Mailing address *
City *
State *
Zip code *
Home phone *
Cell phone *
How long have you lived at your current address? *
If less than a year, indicate previous address *
How is your general health? *
Are you legal to work in the United States? *
State where you hold a driver's license *
Have you ever been known by a different name? *
If yes, please list all other names
Have you ever been convicted of a DUI? *
If yes, please explain
Have you ever been arrested or convicted for any other criminal activities? *
If yes, please explain
Do you have any allergies? *
Do you cook? *
Do you swim? *
Do you drive? *
Do you know CPR? *
Do you own a car? *
Do you drink alcohol? *
Do you smoke? *
High school diploma *
Location *
Years attended *
Year graduated
College
Location
Years attended
Graduated
Year graduated
Majored in
Degree in
Any child related courses?
Previous employment history, beginning with most recent employer *
Employer's street address, city, state and zip *
Employer's phone number *
Why did you leave this position? *
Starting date *
Ending date *
Salary when you left *
Previous employer
Employer's street address, city, state, zip *
Employer's phone number *
Why did you leave this position?
Starting date *
Ending date *
Salary when you left *
Previous employer *
Employer's street address, city, state, zip
Employer's phone number
Why did you leave this position?
Starting date
Ending date
Salary when you left
Personal references (do not list relatives or former employers)
Name *
Address, city, state, zip
Home phone
Nature of relationship *
Years acquainted *
Occupation
Best time to call *
2nd reference name *
Address, city, state, zip *
Home phone
Nature of relationship
Years acquainted *
Occupation *
Best time to call *
3rd reference name *
Address, city, state, zip *
Home phone *
Nature of relationship
Years acquainted
Occupation
Best time to call *
Please contact your references and to let them know we will be calling them.
How would you describe your personality? *
What are your future goals? *
How long do you want to work as a nanny? *
What made you decide to become a nanny? *
What special qualities, skills, and training do you have that will make you an outstanding nanny? *
What are your hobbies/special interests? *
How do you discipline a child? *
Do you play any musical instruments?
Do you play any sports? *
What language(s) do you speak? *
Describe any past event(s) that have shaped your personality in a positive way.
What would you do on a non-school day with a child? *
What can children within your care hope to learn from you? *
Would you be comfortable working for a single parent? *
How would you characterize yourself to a potential family (employer)? *
Are you willing to give a one year committment? *
By initialing in this box you certify that all the answers you have provided on this nanny placement application are true, and complete to the best of your knowledge and that facts have not been omitted *
Date you are completing this online application *

* Fields marked with an asterisk are required fields

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