Nanny Application

Name: *

First Name Last Name
Applying For *

Full-time Part-time Summer Position
Birth Date *

Month Day Year
Phone Number: *
E-mail Address: *

Address: *

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

How did you hear about us? *
Are you eligible to work in the US? *

Yes No
Are you currently employed? *

Yes No
When can you start? *

Month Day Year
Date Date Picker Icon
Days Available to Work: (Check all that apply) *

Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Describe the hours you are available to work: *
Upload Resume: *
Upload your professional resume and cover letter. If the file is too big email it to info@cloud9nannies.com.
Education
Do you have a High School degree? *

Yes No
High School/City
Do you have a college degree? *

Yes No
College and Degree *
Highest level of degree obtained *
Describe any other education experience:
Job Skills & Training
Describe your childcare skills: *
Describe in a few sentences
Describe your personality: *
Describe in a few sentences
What are your favorite activities to do with children? *
Describe in a few sentences
Experience with Special Needs: *
Do you have any physical or lifestyle limitations that would prevent you from being able to do you job?
Describe your comfort level and experience cooking for a family: *
Do you have experience with mulitples?

Yes No
If yes, describe your experience:
Are you CPR/First Aid Certified *

Yes No
Expiration Date of CPR/First Aid Certification: *
What languages do you speak fluently? *
Do you have a valid Drivers License? *

Yes No
Do you have a car? *

Yes No
Are you comfortable with pets?

Yes No
Work History
1. Company/Family *
Start Date *
End Date *
Reason for Leaving: *
2. Company/Family *
Start Date *
End Date *
Reason for Leaving: *
Compensation
What is your required hourly rate? *
Example $15-20/hr
References

Please list three (3) professional references that are familiar with your work life.
Reference 1
Name: *

First Name Last Name
Phone Number: *
Relationship and years know/worked for them:
Reference 2
Name: *

First Name Last Name
Phone Number: *
Relationship and years know/worked for them:
Reference 3
Name: *

First Name Last Name
Phone Number: *
Relationship and years know/worked for them:
Should be Empty:

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