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About
Programs We Offer
Contact
Consultation
Registration
Additional Services
Nanny Services
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Become a Nanny
Looking to be a nanny? We can help you find a home!!
Be a Nanny
Full Name
Address
Phone Number
Email Address
Place of Birth
Have you gone by any other names? (ex. maiden name)
Yes
No
Do you have a valid social security number?
Yes
No
Do You Have a Valid Driver's License?
Yes
No
Are you a U.S. citizen? If not, are you authorized to work in the U.S?
Have you had any motor vehicle moving violations in the last 3 years?
Yes
No
Do you own a car?
Yes
No
Are you willing to use your personal vehicle for work?
Yes
No
Option 3
Is your car insured?
Yes
No
Make, Model, and Year of car
Have you been in any car accidents in the last 5 years?
Yes
No
If you have had traffic violations, or have been in a motor vehicle accident, please explain.
Position Seeking
Nanny
Sitter
Baby Nurse
Please Select One
Full Time
Part Time
Occasional
Languages Spoken
Please List Availability
Please explain any experience with special needs
Name of high school and dates attended
Did you graduate? *
Yes
No
Name of college and dates attended
Did you graduate?
Yes
No
Are you adult and child/ infant CPR certified
Yes
No
Are you First Aid Certified?
Yes
No
Are you applying for a specific position?
Yes
No
If so, please identify the family's name and location
Job #1 Name of Employer
City
Start Date
End Date
Number of Children
1
2
3
4
Ages of Children When You Started
Description of Duties and why job ended?
Phone Number
Job #2 Name of Employer
City
Start Date
End Date
Number of Children
1
2
3
4
Ages of Children When You Started
Description of Duties and why job ended?
Phone Number
Please list a personal reference that has known you for more than 3 years. Please do not list a relative.
Phone number for your personal reference
Tell us a little about yourself. How would you best describe yourself? What do you like to do in your free time?
Can you swim? Do you have any swimming certification? Would you feel comfortable supervising children in water?
Do you have any experience taking care of pets? Do you have any allergies to animals? Would you mind helping to take care of pet(s) in the home where you are the nanny?
Can you cook? Are you willing to learn? Would you cook for kids or even the whole family? Can you grocery shop? What dishes are you most comfortable preparing?
How did you hear about us? Please list anyone who referred you