LPN FAMILY APPLICATION

Lincoln Park Nannies

FAMILY APPLICATION
We are looking forward to working with you to help find a nanny for your family. The information which you provide on the application will help us in the process. We make every effort to be very selective about our nannies and we refer only those nannies to you whom we feel will be a perfect match for your family. Please answer all questions as completely as possible to ensure a successful placement. Upon receipt of your family application we will contact you if further information is needed and send a copy of our working agreement.
Mother's Full Name
Father's Full Name
Current Address
Email Address
example@example.com
2nd preferred email
example@example.com
Phone number
What is your family looking for?
Start date

Month Day Year
Date
Father's occupation
Mother's occupation
Do any of the parents work from home?
Any pets? If so, please describe.
Children

Please describe all the children in your family.
Child 1
Child 2
Child 3
Child 4
Describe your ideal Nanny, i.e. personality, experience.
Describe the Nanny/Family relationship you prefer.
Does your nanny need to drive?
Does the nanny need her own car or will your family be providing one for her use?
Who is caring for the children now?
Do you want your nanny to cook meals?
Do you want your nanny to do the laundry?
Please describe any more important responsibilities the nanny will have. (running errands, grocery shopping, ironing, driving kids to and from school):
Please describe the nanny's hours. What time will the work day begin and end? Do you want your nanny to be flexible with start and end times? Please be very detailed with working hours. Thank you!
Please provide the salary you will provide for your nanny. Most of LPN candidates receive $20-$30 per hour NET depending on their experience.
Thank you for taking the time to fill out our Family Application. Please let us know how you were referred!
Should be Empty:

Lincoln Park Nannies

Children

Please describe any more important responsibilities the nanny will have. (running errands, grocery shopping, ironing, driving kids to and from school):