Family Application

Please complete all required fields. Listed below are various sections so that we can get to know your needs better. We look forward to sourcing your candidate! (Agency Agreement to follow with our agency launch fee)

Full name *

Please provide your full name.

Email *

Please provide your email address.

Phone *

Please provide your phone number.

Street address *

City *

State *

Zip / Postal Code *

How do you prefer to be contacted? *

Have you employed a nanny in the past? *

What Type of Staff Requested? *

Tell us what you're looking for.

Your children

Please tell us about your children.

Child #1

Child's name

Child's gender

Child's age

Describe your child

Salary Rate or Range (hourly) *

*Hourly rates vary based on location, experience, credentials, education, job responsibilities, and the number of children. Given the caliber of candidates we represent, hourly rates start at approximately $20 per hour.

Start date *

What is the ideal start date?

What is the length of commitment expected from the caregiver? *

Childcare Schedule Needed (days & times) *

Estimated total hours per week? *

Will you work at home or outside of the home? *

Can you provide guaranteed weekly pay? *

Does this position require the candidate to have their own vehicle? Or will a car be provided? *

No need to drive We'll provide a car

Do you have pets? *

If yes, please specify type and breed.

Will you require your nanny to be vaccinated? *

Are there cameras in your home? *

Expected duties and responsibilities *

Preparing meals for children Laundry for children Light housekeeping Driving children Homework/tutorin Administering medication if necessary

Are you offering health insurance or other benefits? *

if yes, what benefits offered?

Paid Vacation Paid Holiday Paid Sick Days Mileage Reimbursement Dental Insurance Health Insurance Food Stipend Gym or Country Club Membership

Describe what you are looking for in an ideal candidate? Please include parenting methods and discipline. *

Tell us about what you're looking for.

How did you hear about us? *

I certify the information provided in this application is true and correct to my best knowledge. I understand that The Marla Lane Nanny Agency is a referral service for household employees and our agency does not employ the caregivers. *
The family will be the caregivers employer. I give The Marla Lane Nanny Agency authorization to share details of the information on this application with prospective candidates for the purpose of finding a caregiver for our family however personal information will remain confidential. I understand that there is a separate contract that must be signed and placement fee must be paid before the candidate begins employment.

I agree