Family Application

Full name *

Please provide your full name.

Upload your favorite family photo! *

This may be included when posting the job description to our internal job board & shared with Care Provider.

Email *

This will be the email we send invoices and routine communication to.

Cell number *

You grant MCPC permission to text or call regarding services.

Street address *

MCPC relies on an exact address to coordinate as care team will need to GPS distance prior to accepting.

City *

State *

Zip / Postal Code *

Service Requested *

Tell us what you're looking for.

Family Bio *

Briefly tell us about your family.

What type of position are you seeking to fill? *

Full or part-time nanny, babysitter, temp nanny, summer care, date nights, etc.)

Any developmental delays, diagnoses, or behavioral concerns for the care team to be cognizant of? *

What may be helpful for us to know when working with your child? Ex: ADHD? Please elaborate.

Tell us about your child or children *

Include personality, hobbies, favorite activities, foods, milestones, etc.

Child #1

Child's name

Child's gender

Child's age

Describe your child

Start date

What is the ideal start date?

If no specific date, share details surrounding when you foresee needing help. *

How did you hear about us? *

We track referral sources, and would love to thank whomever referred you!

Pets in the home? Please share any details surrounding your fur baby. *

Will we be asked to feed or let the pet out during the shifts? Do you have a fenced backyard?

Child Allergies, Dietary Restrictions or Special Accommodations? *

What foods shouldn’t the child eat? Cut up into small pieces? — etc.

House Rules & General Expectations *

Any non-negotiable(s) — screen time policies or limitations, family values, rooms the children should stay out of, etc.

Preferred & Requested Schedule *

Any upcoming dates? Please include start & end timeframes.

Is the requested schedule able to be adjusted for the right candidate? *

Is there wiggle room on tweaking hours/days

Disclosure: cameras in the home? *

Please list all locations for legal purposes (perfectly fine, just need locations).

Emergency/spouse name, # & email: *

Outside of emergencies, most families will have both spouses communicating with MCPC so it is helpful to have their name and contact info.

Parking Instructions *

Driveway, street, parking pass or any special notes, etc.

PREFERRED rate — MCPC will email estimated invoice/rate prior to clients accepting the booking: *

Both are a luxury service, but the babysitting is a set rate and the nanny route is for families wanting to hire the nanny outside of the Agency.

If choosing the Placement route, what hourly rate (or range) are you are offering the nanny?

This is NOT for the Babysitting service (nannies are household employees and work for the family once placed).

Upon submission of this application, you immediately receive a next steps email with the link to square away the respective registration amount (depending on which service you request). Some client-families submit their applications, and pay the registration at a later date (until they are needing care), and that is completely fine! Yahoo & some other email addresses could filter my emails to spam, so just something to be mindful of after clicking submit. As a Boutique Agency, clients have direct interaction with me, ensuring a personalized and tailored experience.

Mary Breen, BSW, QMHP-T | Owner

Mary’s Child & Pet Care, LLC

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A referral is the greatest compliment — please share my information with a family or friend who has or will have a childcare need!