Family Registration Form

Family Registration Form

Full name *

Please provide your full name.

Email *

Please provide your email address.

Phone *

Please provide your phone number.

Parent 2 Name

Parent 2 Email

Parent 2 Phone

Street address *

City *

State *

Zip / Postal Code *

Your children

Please tell us about your children.

Child #1

Child's name

Child's gender

Child's age

Describe your child

Job position *

What hourly pay range are you willing to offer? *
The current rate for career nannies in NWI is $18-26/hour depending on experience and job demands. Please select all that apply.

$18-19/hour $20-$21/hour $22-$23/hour $24-$25/hour $26+/hour

Are you willing to tax your nanny, as required by IRS law? (don't worry, we’ll help you with this!) *

Start date *

What is the ideal start date?

What days and hours will care be needed? *

Job description *

Tell us about what you're looking for.

Have you employed a nanny before? *

If you have, what did you like/ dislike about that experience?

How did you hear about Northwest Indiana Nannies? *

Nanny Placement Service pricing is based on the part/full time status of your position. Select your chosen service option to confirm you understand the associated pricing. *

The $250 Registration fee includes the In-Home Consultation. Nanny Placement Service pricing is a half-up front structure: half due as the Client Deposit (to begin recruiting) and half due as the Placement Fee (service fulfilled, due upon hire).

I have read and agree to the terms in the "NWI Nannies Client Agreement"

NWI Nannies Client Agreement Yes