BBNN Family Nanny Application

Please fill out the following

Parent/Guardian 1 Name*
First Last
Parent/Guardian 2 Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Preferred Contact Phone Number*
Secondary Contact Phone Number
Parent/Guardian 1 Email*
Parent/Guardian 2 Email
Parent/Guardian 1 Occupation*
Parent/Guardian 2 Occupation

Family Related Information
Are there any medical situations, special circumstances, food allergies or dietary practices of which we should be aware to facilitate a more appropriate placement? If yes, please explain.*
Do you have any pets?*
What kinds of Pets?
Does the nanny need a car to arrive at the family’s home/location of care?*
If needed, is there parking available for the nanny?*
Will the nanny be required to drive as part of the position?*
Is there a family car available?*
Will the family reimburse the nanny for use of her car?
Do you need a nanny willing to travel with the family?*

Nanny Related Information
What do you anticipate the nanny's child care responsibilities to be?*
Please be specific including meal prep, driving needs and anything additional to childcare.
What housekeeping responsibilities would you like the nanny to have?*
If you are an at home parent, or working part-time, please describe what portion of the time you and the nanny will be working together. What responsibilities will be hers during this time you're at home?
What characteristics are you looking for in a nanny?*
References

Please include a reference for your prospective nanny to call, should she wish to do so. If you have had a nanny, please list him/her as the reference.
Name*
First Last
Relationship to you:*
Reference Phone*
Corporate Code (if applicable):
Are you a current or past Overnight Newborn Care client *
How did you hear about Boston Baby Nurse & Nanny? *
Other (how did you hear about us?)
Are you interested in receiving our monthly Family Newsletter?*

Schedule