Nanny Application

First Name *

Last Name *

Address *

City *

State *

Zip Code *

Phone *

Email *

Comment or Question

How did you hear about us? *

Highest Level of Education/Degree Obtained: *

Are you First Aid and CPR Certified? *

How many years of childcare experience do you have? *

Are you looking for temporary or permanent work: *

Ideal number of weekly hours: *

Pay Rate Desired (Hourly): *

Are you willing to do light housekeeping? *

Do you have experience with multiples? *

Are you comfortable with pets? *

Do you have a safe, reliable vehicle you are comfortable using on the job? *

Do you have children of your own you would like to bring to work? *

Will your schedule change in the next 12 to 18 months? *

Please give a summary of your experiences: *

Reference 1: *

Reference 2: *

Reference 3: *

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