| Are you 20 years or
Older? |
Yes
No |
| Are you First Aid Certified? |
Yes
No |
| Are you Child Care Certified? |
Yes
No |
Have you ever been charged
or convicted of a crime? If yes, please explain |
|
Have you had a criminal
background check in the past 12 months |
Yes
No |
Are you willing to undergo
a criminal backgrounc check? |
Yes
No |
Have you ever been treated
for drug or alcohol abuse? |
Yes
No |
If Yes, please explain the
results and circumstances |
|
Do you have the health and
resilience to meet the demands of caring for energetic young
children? |
Yes
No |
Please Provide a summary
of your childcare experience and training |
|
|
CHILDCARE REFERENCES
Please List at least 3 NON FAMILY childcare
references |
Education:
(Include degrees, seminars, classes, certificates, etc.) |
|
THE FOLLOWING
INFORMATION WILL HELP US PROVIDE YOU WITH THE MOST DESIRABLE
/ SUITABLE NANNY PLACEMENT OPPORTUNITY: |
When will you
be available for placement :
|
Please describe
a desirable Nanny placement/situation for you personally.
What is most important to you in your Nanny assignment? |
Do you prefer
a LIVE-IN assignment or will you have your own apartment
or home (LIVE-OUT)?
|
Describe what
kind of schedule you would be available to work:
|
Can you make a
commitment to at least one year? (Unless applying for temporary
or short-term assignment. If so, please note).
|
What age groups
do you prefer to work with?
|
Would you be willing
to provide light housekeeping services as part of your employment?
YES
NO
If yes, Describe what this might include:
|
| Do you have a license to drive? |
YES
NO
|
| Do you have a car/truck/van? |
YES
NO
|
| Do you have car insurance? |
YES
NO
|
| Who is your insurance provider? |
|
| Are you willing to provide
transportation for children? |
Do you possess the ability
to prepare healthy and appealing meals and snacks for children,
explain?
|
Are you able to swim with
the children in your care? |
YES
NO
|
What Languages do you speak
fluently? |
|
| Do you have any pet
allergies? |
YES
NO
|
| Do you interact well
with pets? |
YES
NO
|
| Best Time to Contact
You? |
Morning
Afternoon
Evening
Anytime
|
Why do you want
to work as a professional nanny?
|
What qualities
do you have that make you an awesome caregiver and nanny?
|
What challenges
or difficulties have you experienced children? How did you
handle the challenges?
|
What do you do
to manage stress?
|
What methods
of discipline do you use with children? Which have you found
to be most effective?
|
What do you do
to foster a positive working relationship with the parents
of the children that you care for?
|
What do you do
for fun and relaxation?
|
How did you hear
about Necessary Nannies?
|
Other Questions,
Concerns, Comments: |
|
RELEASE
I understand that this application is
not an employment contract with Necessary Nannies or any
of their client families. I acknowledge that Necessary
Nannies has not made any promises or representations that
differ from those contained in this paragraph. I understand
that I must provide satisfactory documents to establish
my identity and right to work in the United States and
that failure to do so will disqualify me from being considered
for employment by any clients of Necessary Nannies.
I release and agree to hold harmless any
individual, company, business institution or government
agency from all liability with regard to furnishing information
to and from Necessary Nannies. I release and agree to hold
harmless Necessary Nannies and their clients from all liability
with respect to receipt and distribution of such information.
I understand that investigative background
inquiries to various state, federal, and other agencies
are to be made and may include my consumer credit, motor
vehicle, criminal convictions, and other information. These
reports will include information regarding my work performance
and habits, character, education, work and life experience,
reasons for termination from employment, and claims filed
by me (insurance or otherwise). I authorize, without reservation,
any agency or party contacted to furnish the above information,
and I release all parties involved from liability and responsibility
for doing so. I hereby authorize Necessary Nannies and its
agents to obtain and/or release this information. This authorization
and consent shall be valid in original, fax, email, or copy
form. I understand that Necessary Nannies has the right
to refuse to work with any nanny applicant for any reason
or no reason. I understand that Necessary Nannies is a nanny/caregiver
referral service; and that should I be offered a position,
I will not be an employee of Necessary Nannies; I will be
the direct employee of the Client Family to whom I am providing
my services, and I will be signing an employment agreement
with that party.
I release and agree to hold harmless Necessary
Nannies, its directors, officers, employees, successors,
and assigns harmless from any and all claims, demands, losses,
liabilities, damages, expenses, investigation, or attorney’s
fees arising out of, or in any way related to nanny/caregiver
placement, including any personal injury or property damage
whether such liabilities, claims or demands arise out of
negligent acts of the agency, its clients, or some other
cause.
I certify that all information that I have
furnished on my application is true and complete.
|
| |
(clicking no, will not disqualify you for the position,
we will contact you for approval.) |
