Babysitter and Nanny Application Form

Babysitter and Nanny Application Form
Name*

First NameLast Name
- Birth Date*
  
  MonthDayYear
- NoPrimary SchoolHigh SchoolUniversityHigher Degree
- Major
- What is your highest level of education completed?*
- SingleMarried
- What is your primary language?*
- Are you bilingual or fluent in another language? List Below or type "N/A"
- Baby sittingNanny
- Available Start Date
  
  MonthDayYear
  Date
- What are your desired working hours? *
- What are working hours that you would consider?*
- YesNo
- YesNo
- Part-timeFull-timeOn-call or last minute careWeekendsOvernights
- Any Certificates? First Aid, CPR etc.*
  ex: child care, cooking, language or any
- How many years of childcare or nanny experience do you have?*
- Infants (0-12months)Toddlers (1-3 years)Preschool (3-5 years)Elementary (6-10 years)Pre-teens/Teens (11+)
- Do you have experience working with kids with special needs? If yes, please list below the disabilities.
- YesNo
- Diapering and potty training?Light meal prep for kids?Driving children (if needed)?Light housekeeping?
- YesNo
- YesNo
- YesNo
- YesNo
- If yes, please explain.
- Please list 2-3 references (preferably past families or employers) Include NAME, PHONE NUMBER, RELATIONSHIP, YEARS KNOWN*
- Phone Number*
  Format: (000) 000-0000.
- E-mail*
  example@example.com
- Present Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- File Upload/ Resume Upload*
  
  Cancelof
- Please Describe more about your competence in these work experiences*
  
  Your daily activities with children, cooking, cleaning, etc. 0/250
- Please verify that you are human*
- Phone Number/ Email
  
  469-420-0173 or Blushbloomnannyco@gmail.com
- Signature
- Should be Empty:

Babysitter and Nanny Application Form

Phone Number/ Email