Family Interest Form
Thank you for your interest. This form gives us a better idea of your needs and what your expectations are for your future nanny. Please fill it out in its entirety and we will be in contact soon to schedule a phone conference. We can't wait to connect with you!
Date
-
Month
-
Day
Year
Date
Parent #1 Information
First Name
Last Name
Parent #1 Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent #2 Information
First Name
Last Name
Parent #2 Phone Number
-
Area Code
Phone Number
Email
example@example.com
Number of children in the home?
Gender(s)
Ages
Child #1 Information
First Name
Last Name
Child #2 Information
First Name
Last Name
Child #3 Information
First Name
Last Name
How did you hear about us?
Any allergies, health concerns/disabilities or other information?
Type of Care Needed?
Full-Time/Part-Time
Live-In Nanny
Event/Travel Nanny
Overnight Nanny
Household Manager
After School Nanny
Hourly Wage Offered?
Will you provide any benefits?
Medical Insurance
Paid Sick Days
Paid Holidays
Vision Insurance
Dental Insurance
Schedule of Days and Hours Requested?
Please specify your nannies expectations and responsibilities (example: extracurricular activities, laundry, bathing children, preparing meals, after school pickups, etc.)
Back
Next
Please describe your family dynamics and your day to day (quirks, special activities that you do from day to day?
Pets?
Anything else that we should know?
Submit
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