The Heart State Nanny Agency - Nanny Application

  • THE HEART STATE NANNY AGENCY - NANNY APPLICATION

    Thank you for choosing The Heart State Nanny Agency to assist you in your job search! Please fill out the following application fully to the best of your ability to help us make the best match. *Filling out this application does not constitute employment with The Heart State Nanny Agency and does not guarantee placement. After completing this application we will contact you to set up an interview, and once you are matched for placement we will run a comprehensive background check and contact your references.

  • General Information

  • Pronouns
  • Are you 20+ years old?*
  • Are you legally able to work in the U.S.?*
  • Have you ever been charged or convicted of a criminal offense, excluding any charges or convictions that have been expunged or sealed.*

  • Contact Information

    By filling out this application you consent to be contacted by The Heart State Nanny Agency in order to be eligible for placement. At any time you can revoke consent to be contacted by The Heart State Nanny Agency by emailing us at theheartstatenannyagency@gmail.com and we will remove you from our placement list.
  • Format: (000) 000-0000.
  • How do you prefer to be contacted?*

  • Transportation

  • Do you have a valid US Driver's License*
  • Do you have a reliable vehicle?*
  • Can your vehicle accommodate car seats?*
  • Are you willing to use your vehicle to transport children?*
  • Do you have current car insurance?*
  • Is your vehicle registration current and up to date?*

  • Health and Wellness

  • Do you smoke/use tobacco products?*
  • Do you smoke / vape / use marijuana / THC products?*
  • Do you certify that you do not use illicit drugs / substances or abuse prescription medication?*
  • Are you up to date on vaccinations? (Check all that appy)*
  • If not, are you willing to get vaccinated if a position requires it?*

  • Education

  • Did you graduate high school?*
  • Do you have or are you currently pursuing a college degree?*
  • If you are currently pursuing a degree, how do you take your classes?
  • Do you have any additional training / certifications for childcare? (Check all that apply)
  • Do you possess any of the following skills or abilities

  • Professional Childcare Experience

    In order for us to best understand your skills and experience, please fill out the questions below.
  • How many years of professional childcare experience do you have? (Professional childcare experience is defined as paid work directly with children outside of your family after the age of 18)*
  • Do you have experience with the following ages? (Check all that apply)*
  • Do you have experience in any of the following roles? (Check all that apply)*
  • Do you have experience with any of the following - The Family Makeup (Check all that apply)*
  • Do you have experience with any of the following - Feeding (Check all that apply)*
  • Do you have experience with any of the following - Diapers and Potty Training (Check all that apply)*
  • Do you have experience with any of the following - Sleep (Check all that apply)*
  • Do you have experience with any of the following - Location (Check all that apply)*
  • Do you have experience with any of the following - Transportation (Check all that apply)*
  • Do you have experience with any of the following - Extras (Check all that apply)*

  • Position Preferences

    In order for us to match you with positions that suit you, please let us know what you are looking for in a family.
  • Available Start Date*
     - -
  • Are you willing to make a one year commitment to a family you are placed with?*
  • Position Type (Check all that apply)*
  • Position Title (Check all that apply)*
  • Are you willing to travel for work?*
  • Do you have a current passport?*
  • Are you comfortable cooking for children?*
  • Are you comfortable cooking for a family?*
  • Are you comfortable assisting with light housework?*
  • If yes, check all that apply*
  • Do you have any pet allergies?*
  • Are you comfortable working in a home with nanny cameras and/or security?*

  • References

    The Heart State Nanny Agency will not contact your references until later in the interview process, and once we have received your permission to do so. In order to verify your professional experience and expedite the application process, please provide the contact information of your references below.

  • About You - Nanny Profile

    We would like to get to know you as an individual and as a nanny to make the best match! Your answers to the questions in this section will be added to your nanny profile to be shared with families as well as to direct our placements for a great fit. Please take your time and answer the questions in detail. As this section is about getting to know YOU we would prefer to hear from you and not ChatGBT or other AI. *Answers may be edited for grammar/clarity before sending to families.

  • Tell Us About You

  • Submit Application

    You're almost finished!
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • Please double check your application and make sure that you have answered all questions fully to the best of your ability. You will not be able to return to it for revisions after you click SUBMIT.

  • Should be Empty: