Nanny Application Name * First Name Last Name Email * Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Desired Hours Closest Metro Area * Atlanta Chicago Greenwich/Westchester Nashville If outside a major city, are there certain suburbs you prefer? What is your preferred hourly rate? Are you legally able to work in the United States? * Yes No Do you have a valid drivers' license? * Yes No How many years have you been driving? * If you own a car, what is the make/ model/ year? Are you willing to use your own vehicle to transport children during working hours? * Yes No Have you ever received any traffic violations? * If the answer is "yes," please explain. Have you ever been convicted of a crime? * If the answer is "yes," please explain. When could you start your new position? MM DD YYYY Are there any days/times you're unavailable to work? * Please list your last 3 employers, an overview of duties in each position and include contact information for each. * Do you have any allergies? * Name of High School and year graduated: * Please list any post-High School education/ certifications. Please list any hobbies/ interests. Other than English, any other languages spoken? Date of last CPR/ First Aid Certification? * Are you able to swim, and do you feel comfortable in the water with children? Yes No How would your family and/or friends describe you? What type of family do you feel you'd work best with? What do you love about being a nanny/ house manager? What are your strengths with children and/or in the home? Is there anything else you would like us to know about you? Checkbox I certify that the information in this application is correct to the best of my knowledge. I authorize the release of my driving records, and a criminal background check. Yes No Who can we thank for referring you? Thank you!
