Personal Information
*First Name:
Middle Initial:
*Last Name:
*Street Address:
*City:
*State:
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other State:
*Zip:
*Job ID# (if specific position is being applied for) :
Cell Phone:
*Best Contact Number:
*E-mail:
Emergency Contact Name:
Emergency Contact Number:
*Are you an American Citizen?
Yes
No
*Are you authorized to legally work in the USA?
Yes
No
*Do you have a valid social security number?
Yes
No
*Do you have a valid Driver's License?
Yes
No
*Do you have a car?
Yes
No
*Is your car insured?
Yes
No
*Do you have any motor vehicle violations within the last three years?
Yes
No
*Details
*Has your license been suspended within the last three years?
Yes
No
*Details
*Have you had ANY accidents in the last three years including NO fault accidents?
Yes
No
*If offered a position are you able to make a minimum 1-year commitment?
Yes
No
*Are you available to start immediately?
Yes
No
*Details
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*Do you have any concerns about your National Background clearances?
Yes
No
Details
*What is your birth date? Please Note: You must be 18 years old to be considered for representation
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*Have you ever been a Nanny before?
Yes
No
*Do you smoke?
Yes
No
*Are you able to swim?
Yes
No
*Are you CPR Certified?
Yes
No
*Details
*Are you willing to become CPR Certified?
Yes
No
*Are you First Aid Certified?
Yes
No
*Do you fluently speak any other language?
Yes
No
*Details
*Do you prefer to work for a family that does all the payroll deductions for you?
Yes
No
*Do you have any experience working with TWINS or multiple children at the same time? If so, please elaborate.
Yes
No
*Details
*What is your marital status?
Single
Married
Divorced
Widowed
*Do you have children? (it's optional to answer so you can put NO if you'd rather not disclose but many parents find "real life" experience beneficial)
Yes
No
*Details
*How old are they?
0-12 years
older than 12
0-12 years
*What arrangements have been made for your child/children during the time period you would be working?
*Some families prefer their nanny comes in uniform such as nurse scrubs; are you interested in positions that have this requirement?
Yes
No
*Do you know ANY sign language? Many families are introducing baby sign language before verbal communications!
Yes
No
*Do you enjoy reading to children? If so, please list out your favorite books to read to children. (Titles & Authors if possible)
Yes
No
*Which One?
*Do you intend to drive a vehicle to and from your nanny position?
(versus public transportation)
Yes
No
*Please provide the make, model, year and color of the vehicle you will utilize.
*Do you ENJOY cooking? If so, please describe a handful of specific meals you would feel comfortable preparing for the family that hired you!
Yes
No
*Details
*Is it safe to say you feel you have qualifications that make you more outstanding than other nannies that may be applying for the same role? If so, please explain what makes you stand out?
Yes
No
*Details
*Would you consider a live IN nanny position where your primary residence is the same as where you work?
Yes
No
*Do you feel you come from a close knit family?
Yes
No
*Do you participate in ANY form of volunteer work in your personal life?
Yes
No
*Do you consider yourself to be an outdoor person who enjoys sports and keeps physically active?
Yes
No
*Please tell ABC a little about yourself! (suggestions below)
Do you play any instruments, if so, what do you play?
Do you play any sports; if so, what sports do you enjoy?
Do you have any special talents that you feel would be beneficial as a nanny?
Where did you grow up? How many siblings do you have?
*What is the highest level of education you have completed?
HS Diploma or GED
Some College
Associate's Degree
Bachelor's Degree
Master's Degree
*Please list subjects of study and any certifications attained:
*Name of the College you attended:
*Would you describe yourself as a high energy Nanny?
Yes
No
*Please explain your view/work ethic when it comes to cell phones, social media and TV watching during your work day as a nanny?
*Many families have pets in their home. Please tell us about your love of pets, your comfortability caring for them and what pets you have.
*Please describe yourself in detail concerning your personality, goals, family background, and why you want to be a Nanny.
Please fill in the blanks
*The reason I have chosen to be in the Nanny profession over any other is because:
I have been serving in some form of childcare for over
years and can honestly say that I
what I do!
*I feel children are:
*My goal as a Nanny is to:
*I am willing to do housekeeping that includes:
*If I had to describe myself in five adjectives I would say that I am:
*Activities that I would like to incorporate in the daily plan for the family I care for would include:
*If asked to describe the perfect family seeking a Nanny like me I would hope they would be:
Position Desired
*Check all that apply!
*Do you consider yourself to be tech savvy? (able to communicate with parents through text, order groceries and/or order items online)
Yes
No
*Are you comfortable providing homework help if necessary?
Yes
No
*Do you play any instruments?
Yes
No
*Drug testing through Quest Diagnostics is required for representation. Are you comfortable submitting to this screening?
Yes
No
*Please check the age group of children you prefer to care for (check all that apply)
*What capacity of childcare experience do you have? Check all that apply.
Details
Childcare References: Please list prior childcare positions you have held, beginning with your most recent childcare position and going back as many years as possible. Please feel free to include all nanny positions, daycare positions, babysitting as needed care, doula care, summer only camp counselor classroom setting positions and ANY child care capacity opportunities you've held. Contact information to verify references is critical so please be sure to include all necessary fields. Parents like to speak with other parents so it's perfectly okay to provide parent names and numbers instead of Institution/Daycare names and numbers if preferred.
*Most Recent/Current Position Title:
*Description of Position
(indicate Full time or Part time)
*please include ages of children when you started & reason for leaving:
*Dates of Employment:
*Starting Pay and Ending Pay:
*Direct Supervisor Name:
*Direct Supervisor Contact Number and Email:
*Prior Position Title:
(directly previous to most recent/current):
*Description of Position:
(indicate Full time or Part time)
*please include ages of children when you started & reason for leaving:
*Dates of Employment:
*Starting Pay and Ending Pay:
*Direct Supervisor Name:
*Direct Supervisor Contact Number and Email:
*Additional Position:
*Description of Position:
(indicate Full time or Part time)
*please include ages of children when you started & reason for leaving:
*Dates of Employment:
*Starting Pay and Ending Pay:
*Direct Supervisor Name:
*Direct Supervisor Contact Number and Email:
Additional Position:
Description of Position:
(indicate Full time or Part time)
*please include ages of children when you started & reason for leaving:
Dates of Employment:
Starting and Ending Pay:
Direct Supervisor Name:
Direct Supervisor Contact Number and Email:
Additional Position:
Description of Position:
(indicate Full time or Part time)
*please include ages of children when you started & reason for leaving:
Dates of Employment:
Starting and Ending Pay:
Direct Supervisor Name:
Direct Supervisor Contact Number and Email:
Additional Position:
Description of Position:
(indicate Full time or Part time)
*please include ages of children when you started & reason for leaving:
Dates of Employment:
Starting and Ending Pay:
Direct Supervisor Name:
Direct Supervisor Contact Number and Email:
Personal References (Examples: neighbors, family members, mentor/teachers, friends, church leader/pastor etc.) Please list any references below that can support your charachter in terms of honesty and integrity.
*Personal Reference Name(s):
*Relationship and Details:
*Dates known:
*Contact Number(s):
*Email Address:
*Personal Reference Name(s):
*Relationship and Details:
*Dates known:
*Contact Number(s):
*Email Address:
Personal Reference Name(s):
Relationship and Details:
Dates known:
Contact Number(s):
Email Address:
Thank you for your application, an ABC Nanny Source Scheduling Coordinator will be contacting you promptly to review your information!
We look forward to sharing in your success as an outstanding ABC Nanny!
Sincerely,
ABC Nanny Source