Nanny Application

Nanny Application

We are so excited that you are here! Please answer all questions in its entirety. If something doesn't apply, please fill out that section with N/A. After submission we will email you a confirmation and be in contact to ask for your resume and any additional information that we may need. Once we have verified all of your information, we will then call to schedule an interview and request more information for a thorough criminal background check. We look forward to connecting with you and your potential forever family.
Date*

MonthDayYear
Date
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Birthdate*
Are you legally able to work in the United States?*
Other Names Used?*
How did you hear about us?*
Are you registered with any other agency? Are you actively working with them? Which agency?*
NOTICE: PLEASE READ AND SIGN

This application form is intended for use in evaluating your suitability to be referred by our agency to available positions. It is not an employment application or contract. I certify that the information provided by me in this application (and accompanying resume, if any) is true and complete to the best of my knowledge and belief. I authorize Nannies Infinity, LLC. or its representatives to investigate all statements contained in this application. I understand that any false information, omissions or misrepresentations of facts may result in rejection of my application. I authorize any person, school, current employer (unless otherwise noted in this application form), past employer(s), and organizations named in this application form (and accompanying resume, if any) and any other person or entity with knowledge of me to provide Nannies Infinity, LLC. with any information and opinion which Nannies Infinity regards as useful to it in making a referral decision. I release such persons and organizations from any legal liability in making such statements, or furnishing any and all information that the Agency may seek. I understand that I will not have access to the confidential information received however, according to the Fair Credit Reporting Act, I am entitled to know if employment is denied because of information obtained from a Consumer Reporting Agency. I agree to relieve Nannies Infinity, LLC. of any liability or consequences that might result from obtaining said information from others.
Signature*

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What Type of Employment are you looking for?*

Full Time (more than 35 hrs/wk)Part Time ( 35 hrs or less/wk)Summer/Event NannyDate Night/Evening Nanny
CHILDCARE HISTORY FOR LAST FIVE YEARS

PLEASE INCLUDE RELEVANT CHILDCARE EXPERIENCE NOT LIMITED TO BUT INCLUDING BABYSITTING, DAYCARE PROVIDER, SCHOOL TEACHER AND NANNYING POSITIONS.
Dates Employed*
Name of Employer*
Phone Number*
Address*
Ages of Children Cared for*
Position Type*

Nanny PositionBabysittingDaycareOther
Describe Duties*
Reason for Leaving*
Dates Employed*
Name of Employer*
Phone Number*
Address*
Ages of Children Cared for*
Position Type*

Nanny PositionDaycareBabysittingOther
Describe Duties*
Reason for Leaving*
Dates Employed*
Name of Employer*
Phone Number*
Address*
Ages of Children Cared for*
Position Type*

NannyDaycareBabysittingOther
Describe Duties*
Reason for Leaving*
Dates Employed*
Name of Employer*
Phone Number*
Address*
Ages of Children Cared for*
Position Type*

NannyDaycareBabysittingOther
Describe Duties*
Reason for Leaving*
Dates Employed*
Name of Employer*
Phone Number*
Address*
Age of Children Cared for*
Position Type*

Nanny PositionDaycareBabysittingOther
Describe Duties*
Reason for Leaving*
CHARACTER REFERENCES

PLEASE PROVIDE NAMES AND ADDRESS OF 3 PEOPLE NOT PREVIOUSLY LISTED WHO YOU HAVE KNOWN FOR AT LEAST 5 YEARS. DO NOT LIST RELATIVES, SIGNIFICANT OTHERS, OR THEIR RELATIVES
Name*
Address*
Phone Number*
Relationship*
Name *
Address*
Phone Number*
Relationship*
Name*
Address*
Phone Number*
Relationship*
Are you a fluent English speaker? (do you speak any other languages?)*
Why do you want to be a nanny?*
Are you currently in school? For how long? Major?*
Are you CPR/First Aid certified? include class dates and card expiration date*
Have you taken any childcare related trainings?*
What have you done (classes, trainings, coursework, volunteer work) in the last 12 months to increase your knowledge of childrens developmental needs?*

What days and times are you available to work? Holidays?*
Do you smoke?*
Are you willing to work in a non-smoking environment?*
Any Allergies?*
Would you be willing to complete a medical exam?*
Would you be willing to submit to a drug screening?*
Date you are able to start?*

MonthDayYear
Date
RELEASE AND AUTHORIZATION FORM

RELEASE AND AUTHORIZATION FORM TO BE COMPLETED BY THE NANNY APPLICANT

DISCLOSURE: A CONSUMER REPORT MAY BE PROCURED FOR EMPLOYMENT PURPOSES I voluntarily and knowingly authorize for employment purposes only, any present or past employer or supervisor, university or institution of learning, administrator, law enforcement agency, state agency, federal agency, credit bureau, private business, military branch or the National Personnel Records Center, Open Online, personal reference, and/or other persons, to give records or information they may have concerning my criminal history, motor vehicle history, earnings history and employment records any other information requested to Nannies Infinity, LLC., U S Information Search, Employment Screening Services, Inc. I voluntarily and knowingly unconditionally release any named or unnamed informant from any and all liability resulting from the furnishing of this information. A photographic or faxed copy of the authorization shall be as valid as the original. According to the FAIR CREDIT REPORTING ACT, I am entitled to know if employment is denied because of information obtained from a Consumer Reporting Agency. I will also be given a summary of my rights and a copy of the consumer report.
Signature*

Clear
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