Family Application

Parent/Guardian 1 Full name *

Please provide your full name.

Parent/Guardian 1 Occupation *

Parent/Guardian 1 Email *

Please provide your email address.

Parent/Guardian 1 Phone *

Please provide your phone number.

Parent/Guardian 2 Full name

2nd Parent / Guardian's Occupation

2nd Parent / Guardian's Email

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

What care is your family looking for? *

Type of Childcare you require: *

If Live In, describe the nanny’s living quarters (IE: Guest House, Own Bedroom, Private Quarters, etc):

Job description *

Tell us about what you're looking for.

Start date *

What is the ideal start date?

Do any of the parents work from home? *

Please describe your family lifestyle *

Please list any skills or abilities you desire in a nanny. *

Describe the Nanny/Family relationship you prefer *

Does this position require the candidate to have their own vehicle? *

If driving is required, roughly how many miles per day?

Do you wish to have your nanny use their own vehicle to transport your children to/from school or activities? *

If nanny must use own car, will gas/ mileage be compensated if nanny uses her own car?

Have you ever employed a nanny or assistant before? *

Who is caring for the children now? *

Is your family comfortable or open to the possibility of having your nanny bring her own child/children to work? *

Preferred Schedule *

Please tell us your preferred week schedule.

Paid Personal Days Paid Vacation Time Health Insurance Other No Benefits

Prep and Cook Meals Children's Laundry Light Housekeeping Other

What are your preferred discipline methods? *

Describe some unique and appealing benefits the nanny would experience if they were to work for your family? (e.g. we offer opportunity to travel with us, holiday bonus, etc.) *

Do you require your nanny to travel with your family? If so, please describe *

What is the salary range you are offering? *

We suggest no less than $25 per hour, especially if you have more than one child.

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

Are you willing to guarantee hours? *

Is there any additional information about your family/family situation that our team should know before beginning your search? *

Have you ever used a referral agency before? *

Please tell us how you were referred? *