Nanny Registration Form

Nanny Registration Form

First Name *

Last Name *

Preferred name/Nickname

Email *

Please provide your email address.

Phone *

Please provide your phone number.

Street address *

We only place nannies in positions within Northwest Indiana. In order to be represented, you must live locally (within 30 minute drive to NWI Indiana) with a local address.

City *

State *

Zip / Postal Code *

Preferred Schedule *

How many hours/week of work are you seeking?

Do you have a legal right to work in the United States? *

Do you have a valid driver's license? *

Due to the nature of the jobs we have, having a valid and active driver's license is required.

Please upload a picture of your Driver's License.

Note: this is not required at this stage. You can wait until the interview to show us your valid Driver's License.

Do you have a high school diploma or equivalent? *

Have you worked with a nanny or care giving agency before? If so, which one(s)?

How did you hear about Northwest Indiana Nannies? *

If you were referred by another nanny, please tell us their name so we can thank them!

How many years of professional experience do you have working with children? *

**NOTE: This includes long term nanny positions, teaching, daycare, professional tutoring, etc. This DOES NOT include babysitting or caring for family members. **

Can you commit to at least 1 year? *

There are no penalties if you must leave a position within the first year, but we hope to make lasting and meaningful long-term matches for our Families & Nannies

Which groups do you have at least 6 months of experience with? *
Please select all that apply.

Infant (0-12 months) Toddler (1-2 years) Preschool (3-4 years) Grade School (5-12 years) Teenagers (13-17 years) Special Needs (any age) Other

Specific Nanny Experience *
Select all that apply.

1-4 years experience as a nanny 5+ years experience as a nanny Nanny experience with a WFH parent Experience with twins Experience with triplets Summer nanny experience Mother's helper experience 2+ years experience as a regular/on-going babysitter House management experience

Related Work Experience
Select all that apply.

College Studies and Courses: *
Select all that apply.

Training and Certificates: *
Select all that apply.

Profession Related Skills: *
Select all that apply.

Athletic Swimmer Creative/artistic Educated/homework help Bilingual Multilingual Good Cook

Ethical Values: *
Pick 2 that best describe you.

Reliable Trustworthy Loyal Honest Patient Benevolent/Charitable Disciplined

Personality Traits: *
Pick 2 that best describe you.

Warm Caring Open Straightforward Competent Positive Calm & Collected

Intellectual Strengths: *
Pick 2 that best describe you.

Intelligent Educated Creative Energetic Self-confident Communicative

Character Strengths: *
Pick 2 that best describe you.

Sincere Positive attitude Sense of Humor Polite Mature Integrity

Cooperation and Decision Making: *
Pick 2 that best describe you.

Rule and Directions Follower Able to accept constructive criticism Able to make decisions on my own Able to take initiative Have good common sense

Diligence: *
Pick 2 that best describe you.

Hard working Organized Detail oriented Punctual Neat

Hobbies *
Select your top 3-5.

Please upload a clear and pleasant head shot with minimal editing/filters for your profile.

Note: this is not required. You can wait until after the screening process is complete to provide a head shot.