Quality Nanny Placements, LLC • Nanny Application

Please note that our agency requires a minimum of 3 years nanny experience in order to be considered for a position. If you do not meet this requirement, you will be denied. Some exceptions are made for candidates with related experience such as teachers and long-term daycare providers.

**We are now hiring for On-Call Caregivers in the following states:

New York
New Jersey
Connecticut
Iowa
Utah
Nevada
Delaware
Pennsylvania

Contact Information

First & Last Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Main Contact Number *

Area Code Phone Number

Other Contact Number

Area Code Phone Number

Is this your mobile number?

Yes No

Email Address *

Skype ID

Start Date

Date Date Picker Icon

Birth Date *

Month Day Year

Do you have a driver license? *

Yes No

Driver's License Number

This is for your required driving record check

Do you own a vehicle?

Yes No

If yes, what type of vehicle do you own?

Ex: Sedan, SUV, Van, Truck, Jeep, etc.

Please specify what type of position you are interested in applying for. *

Live-In Live-Out Full-Time Part-Time Any

Can you commit to working at least one year with a family? *

Yes No

Have you ever been arrested? *

Yes No

In the event of an emergency, are you able to swim? *

Yes No

Do you smoke? *

Yes No

Do you speak any languages other than English? *

Yes No

If yes, what other language(s) do you speak?

Are you physically able to climb stairs throughout the day and chase after small children without any difficulty? *

Yes No

Do you have children?

Yes No

Do you have reliable childcare for your children?

Yes No

If yes, what are their ages?

Do you have paid experience working with infants? *

Yes No

Do you have experience working with special needs children? *

Yes No

If yes, please list any experience that you may have with special needs children.

I am: *

willing to work in a home with pets. able to prepare basic meals. able to travel with a family. available to work occasional overnights. comfortable working with infants. None of the above

CPR Certified *

Yes No Expired

Expiration Date

Month/Year

First Aid Certified *

Yes No Expired

Expiration Date

Month/Year

Education History:

Highschool *

Name

Did you graduate? *

Yes No

Date of Graduation *

Year

Did you attend College? *

College

Date of Graduation

Degree

Do you have additional Education to add?

College

Date of Graduation

Degree

Employment History:

Employer 1:

Employer's Name *

First Name Last Name

Employer's Address *

Street Address
Street Address Line 2
City	State / Province
	Country

Employer's Contact Number *

Area Code Phone Number

Your Job Title *

Start Date *

Month/Year

End Date *

Month/Year

Number of Children *

Ages of children when you started *

ex: 4 years, 7 years

Salary

List any responsibilities that you had *

Reason for leaving *

May we contact this employer as a reference check? *

Yes No

Employer 2:

Employer's Name

First Name Last Name

Employer's Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Employer's Contact Number

Area Code Phone Number

Your Job Title

Start Date

Month/Year

End Date

Month/Year

Number of Children

Ages of children when you started

ex: 4 years, 7 years

Salary

List any responsibilities that you had

Reason for leaving

May we contact this employer as a reference check?

Yes No

Employer 3:

Employer's Name

First Name Last Name

Employer's Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Employer's Contact Number

Area Code Phone Number

Your Job Title

Start Date

Month/Year

End Date

Month/Year

Number of Children

Ages of children when you started

ex: 4 years, 7 years

Salary

List any responsibilities that you had

Reason for leaving

May we contact this employer as a reference check?

Yes No

Final Questions:

Please answer each question as best you can. The more detail involved, the better idea the families will have of you!

Briefly describe why you enjoy being a nanny *

Briefly, sum up what you have been doing for the last 3 years in your career *

List one positive memory that you have from working as a nanny *

Describe your beliefs about disciplining children *

Describe your personality *

Describe your hobbies and interests *

Describe your childhood and how you were raised *

Tell us what you think makes a great nanny *

List anything else that you would like the family to know about *

How did you hear about Quality Nanny Placements? *

Is there a particular listed position you are interested in? If so, please list the name of the town for that job: *

Town of position you are interested in

By checking the 'Yes' box below, you are verifying that you are legally authorized to work in the United States. *

Yes No

By checking the 'Yes' box below, you are verifying that you are agreeing to a background & driving record check. *

Yes No

By checking the 'Yes' box below, you are verifying that you are agreeing to commit to a minimum of one year with a family if you are placed *

Yes No

File Upload:

(This is NOT mandatory)

Photo

Upload a Photo

Limited to (2) photos; please make sure the photo is labeled as your name

Nanny Resume

Upload a File

Please make sure the file name is your first and last name

Please review your application and make sure that all of your information is correct before applying.

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Quality Nanny Placements, LLC • Nanny Application 2016