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  Washington, DC's Premier Nanny Placement Service Serving DC, MD, VA

Application

Level
Nanny Application (Free) Subscription period: Monthly Automatic renewal: no

Fill in application form

Application form

* Mandatory fields
 

 

*e-Mail
*First Name
*Last Name
*Primary Phone
*Password
 
 

Contact Information

*Address 1
Address 2
*City
*Postal code
*How long have you lived at this address?
Previous Address (if less than 2 years)
Home Phone
Cell Phone
Work Phone
What is the best time to reach you?
 

Tell Us About Yourself

Photo
*Date of Birth
Social Security Number (SSN)/Work Permit #
*What is your citizenship?
How many children do you have?
*Please describe yourself in detail:
What are the ages of your children?
*Have you ever been convicted of a crime? If yes, please explain.
What languages do you speak fluently?
Is English your first language?
*Do you drive?
*Do you have a car?
Driver's License Number
Driver's License State
Can you swim?
Are you certified in any of the following?
What classes are you interested in taking?
Do you smoke?
Do you drink?
Do you use drugs?
Are you willing to submit to a drug test?
Do you have a handicap or disability which might prevent you from performing any household duties?
If you answered 'Yes' to the previous question, please explain.
Have you ever had a nervous breakdown or been under psychiatric care? If yes, please explain.
 

Work Preferences

*Date Available
*Job Location Preferences
*Type of work desired (check all that apply)
*What days are you available to work?
What hours would you like to work?
*Are you willing to travel with a family?
*Which would you prefer to work with (check all that apply):
*Duties willing to perform in addition to childcare:
Are you willing to commit to at least one year of service?
 

Reference #1

*Reference #1 Name
*Reference #1 Phone Number
*Address for first reference
*How do you know this first reference?
 

Reference #2

*Reference #2 Name
*Reference #2 Phone Number
*Address for second reference
*How do you know this second reference?
 

Reference #3

*Reference #3 Name
*Reference #3 Phone Number
*Address for third reference
*How do you know this third reference?
 

Employer #1

*Employer #1 Name
*Employer #1 Address
*Employer #1 Phone
*Employer #1 Position Dates (from/to)
*Employer #1 Starting Pay
*Employer #1 Ending Pay
*Employer #1 Reason for Leaving
 

Employer #2

Employer #2 Name
Employer #2 Address
Employer #2 Phone
Employer #2 Position Dates (from/to)
Employer #2 Starting Pay
Employer #2 Ending Pay
Employer #2 Reason for Leaving
 

Employer #3

Employer #3 Name
Employer #3 Address
Employer #3 Phone
Employer #3 Position Dates (from/to)
Employer #3 Starting Pay
Employer #3 Ending Pay
Employer #3 Reason for Leaving
 

Nanny Requirements

*How did you hear about us?
 

Agreements (opens in new window)

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