Nanny Placement Registration Form

Getting to know you is an important first step in our process. It is important you fill out your application in detail as we will use the information you provided to establish the foundation for your search. After completing the form below, please review our Client Service Agreement. You will receive an automated email to sign it electronically after completing the registration form.

If you have questions about our terms or fees, feel free to contact us directly at 714-716-7036.

Please note: Pacific Elite Nannies works exclusively with parents seeking Full Time Placements and Newborn Care Specialists. We look forward to expanding to offer Part Time candidates in the near future.

Parent 1 Full Name *

Please provide your full name.

Occupation *

Parent 2 Full Name *

Please provide your full name.

Occupation *

Email *

Please provide your email address.

Phone *

Please provide your phone number.

Preferred Method of Contact *

Street address *

Street address Line 2

City *

State/Province *

Zip / Postal Code *

Country *

Job position *

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

Anticipated start date *

Please keep in mind that because we do a customized search for each family, it can take up to 2-8 weeks to be placed with a nanny. We will do our very best to place as soon as possible.

Weekly Schedule Needed *

Please tell us your preferred week schedule.

What are you looking to pay the nanny hourly? *

Are you prepared to pay the nanny on payroll? *

Job responsibilities *

Qualities and requirements you are looking for in a nanny *

Concerns (privacy/health, etc) *

Do you work from home? *

Do you have pets? If so, what kind? *

What is your philosophy regarding discipline? *

What has been your experience with previous child care situations? *

Describe your family *

How many Paid Vacation days are you offering? *

Full time nanny Industry standard benefits include: guaranteed hours, two weeks paid vacation, 8 - 10 paid holidays, 3- 5 sick days, and mileage reimbursement. Please specify below the amount of days you are offering for paid vacations, holidays and sick days.

Paid Vacation days (other)

If other please specify.

How many Paid Sick days are you offering? *

Paid Sick days (other)

If other please specify.

Please confirm that you are willing to compensate the nanny for mileage at the most up-to-date IRS rate, while on the job. *

Is the nanny required to swim? *

Is nanny required to travel with family? *

Any additional information Pacific Elite Nannies must know?

Do you require your nanny to be driving? *

Will you provide a car for her to use while on duty? *

How did you hear about Pacific Elite Nannies? *