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Name:
Address (complete address with street, city and zip code):
Candidate Biography: (Please write a little bit about yourself and your experience)
Main
Home Phone:
Cell Phone:
Email:
Available for interview?
Yes
No
Over 18?
Yes
No
Date of birth
Eligible to work in the U.S?
Yes
No
Do you have a Work Visa?
Yes
No
Comments:
Position Applying For: (Check all that apply)
Part Time Nanny
Full Time Nanny
Live-in Nanny
Babysitter
Newborn Specialist
Caregiver
Housekeeper
Special Needs Nanny
Elderly Care
Are you currently employed?
Yes
No
May we contact your employer?
Yes
No
When can you start?
Hours willing to work per week?
Gross hourly rate?
Weekly salary requested?
Yes
No
Additional wage comment:
Availability: (Check all that apply)
Full time live in
Full time live out
Part time live out
Part time live in
Part Time Nanny
Babysitting
Evenings
Weekends Only
Overnights
I'm flexible
Schedule:
Sun:
Mon:
Tues:
Wed:
Thurs:
Fri:
Sat:
If you are flexible on the hours for that day write `Flexible`. If you have specific hours write those in. For e.g. 8-5.
Comment:
Education
What level of school did you complete?
Name of High School:
College:
Location:
Subjects Studied:
Any specialized training? If so, what training?
Any certificates? If so, please list:
Employment (Please add at least 3 employment references)
Employer name
Address:
Date from:
Date to:
Position Type:
Number of children:
Ages of children when started? When you left?
When you left?
Responsibilities:
Starting Salary:
Ending Salary:
May we contact?
Contact Phone:
Contact Email:
Reason for leaving:
Hours worked:
Was this a live in position?
Work Comment:
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Personal References (Please add at least 2 personal references)
Name:
Address:
Contact Number:
Contact Email:
How do you know this person?
Years known:
Add More
Questions
Years of childcare experience:
What ages will you work with?
What ages do you have the most experience with?
Have you cared for twins or multiples?
Do you have special needs experience? If so, what kind?
Would you tutor? If so, what subjects?
Will you do any housekeeping? If so, please check off the duties you will perform.
Clean main living areas
Clean bathrooms
Clean children's rooms
Vacuum
Wipe down kitchen counters
Clean dishes/put dishes away
Mop floors
I am fine with heavy cleaning
I will only do light housekeeping
I will not do ANY housekeeping
Why do you want to be a nanny?
What type of activities would you do with the children?
If you were a parent looking for a nanny, what characteristics would you look for?
Do you have any background in child development? If so, how many units?
How many children will you care for?
Would you care for sick children?
Will you assist children with homework?
Briefly tell us about your family life?
What are your interests?
What is your philosophy on discipline?
What is most important for a good relationship between a nanny and parents?
Rate yourself on communication skills: (1-10)
Housekeeping (skip if you are not a housekeeper)
How many years experience?
What is the largest house you have cleaned? ( For ex. 6 bedrooms)
Will you perform laundry and ironing?
Yes
No
What best describes your housekeeping standards? (check off)
Extremely Thorough
Neat & Orderly
It`s Good, Not Great
Rate yourself on communication skills: (1-10)
Rate yourself on organizational skills: (1-10)
What is your personal style of service? (check one)
Professional
Laid Back but professional
Part of Family
Have you worked in a private household? How long?
Are you willing to work at home with a child?
Yes
No
Are you willing to help the family with childcare when needed?
Yes
No
Describe the type of household duties you are NOT willing to perform:
Questions
CPR certified?
Yes
No
First Aid Certified?
Yes
No
Do you need to get your CPR or First Aid renewed?
Yes
No
Have you had a TB test?
Yes
No
Have any pet allergies?
Yes
No
Do you smoke?
Yes
No
Will you work at home with a parent that smokes?
Yes
No
Will you travel with the family?
Yes
No
Any travel restrictions?
List all cities you have lived in and for how long:
Have a valid passport?
Yes
No
Will you work in a home with a parent that is home?
Yes
No
Miles you are willing to commute:
Do you have a child of your own you need to bring?
Yes
No
Work with a dog or cat at home?
Yes
No
Do you swim?
Yes
No
Would you wear a uniform or dress code?
Yes
No
Have you ever been convicted of a crime? If so, please explain:
Driving
Do you drive?
Yes
No
Have a car?
Yes
No
Car make, model and year:
State your license was issued:
Have car insurance?
Yes
No
What company?
Had any traffic citations (including DWI, DUI)?
Do you have a license that is valid and not under suspension?
Yes
No
Will you use your car for work purposes?
Yes
No
Have you had traffic citations in the last 5 years? If so, please list:
About You
What extra curricular activities/special skills or hobbies are you interested in?
Describe the type of family you would like to work for:
What are your short term goals?
Why do you think you are qualified for this position?
What languages do you speak?
Please attach your CPR/First Aid here:
Please attach any certificates here:
Please attach any reference letters here:
Please attach trustline here (if you have):
I agree to
Loving Nannies Terms and Conditions
(You will need to click on and read the Terms and Conditions and then check off the box to move forward and save your application.)
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