Family Application Form – Permanent Placement Nannies

Your Name

Your Email

Your Phone Number

Your Address

What type of childcare are you looking for?
Full-time NannyPart-time NannyLong-term PlacementShort-term PlacementNanny Share?Other? (explain below)

How did you hear about us?

Does your child(ren) have any allergies?
YesNo

Any medical conditions or medications?
YesNo

Do you have pets?
YesNo

Provide some important information about your family. Eg. Ages of your children, your location/neighborhood, number of children, etc.

What would your nanny’s schedule look like? Please include the days and times.

What are the rate ranges per hour that you would prefer to pay your nanny? Please note, the rates for nannies range from $24.00 - $35.00 per hour or more. The rate for nannies varies depending on the job responsibilities, education and experience.

Describe your ideal nanny. Example: many years of experience, ECE certified, drivers license, speaks another language, special needs training, etc.

What are your expectations for your nanny? Ex. Light meal prepping, light housekeeping, cooking, assisting with homework, teaching another language, etc.

Would you like to share your family's philosophies on parenting?
YesNo
If yes, please explain.

What are some of your concerns that you would like to discuss with us?

Any additional comments or things you'd like us to know?

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