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Application

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Prospective Family Application :
Please Fill out the following application. Use the tab key or mouse to move between fields.
Is this nanny position:
Live-In
Live-Out
Application Date: 
Position Start Date: 
PARENT RELATED INFORMATION
Parent 1 Name:
 Parent 2 Name: 
Parent 1  Street Address:
 Parent 2  Street Address:
Parent 1 City or Town:

 State:  Zip:  		Parent 2 City or Town:

State:  Zip: 
Parent 1 Home Phone Number: Parent 2 Home Phone Number:
Parent 1 Work Phone Number: Parent 2 Work Phone Number:
Parent 1 Cell Phone Number: Parent 2 Cell  Phone Number:
Preferred Contact Number: Parent 1 Cell Parent 1 Home Parent 1 Work
Parent 2 Cell Parent 2 Home Parent 2 Work
Parent 1 Email:
 Parent 2 Email:
Parent 1 Occupation:
 Parent 2 Occupation:
 

Should nanny portfolios be:
Mailed
Faxed
Sent Via e-mail

 

If mailed, please provide name and address:

If faxed, please provide fax info:

If sent via e-mail , please provide email address:

As some of our candidates are not email accessible please include a second choice.
What is your proposed weekly salary?

Live-In
Live-Out

Are there any other benefits you can offer a nanny, such as health insurance, tuition reimbursement, bonuses, family vacations, tennis/health club membership, etc.
Nanny's work schedule as you anticipate it to be. Please allow for two consecutive days off:  
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:

CHILD RELATED INFORMATION
Children living in your home:
Name Age Sex Birthdate School Hours

Is a new child expected? If yes, please estimate birth date: 

Briefly describe each child, giving an idea of their temperament, likes, dislikes, etc.
FAMILY RELATED INFORMATION
Please describe yourself. Write about your  life style, home activities, etc. 
Which of these styles of housekeeping best describe your household?
Tidy & clean; everything in its place.
The lived-in look; newspapers and toys in areas where activities are ongoing.
Clutter does not bother me.
Other - please comment.
Are there any medical situations of which we should be aware in order to facilitate a more appropriate placement?
Do you have any pets? If yes, for what part of their care is the nanny responsible?
Do you follow any dietary practice to which you would like a nanny to adhere?  If so, please describe your requirements.
Who, in addition to parents and children, lives in your home?
Will you have any household help other then the nanny? If so, please describe:

NANNY RELATED INFORMATION
What do you anticipate the nanny's child care responsibilities to be? 
What housekeeping responsibilities would you like the nanny to have?
If you are an at home parent, or working part-time, please describe what portion of the time you and the nanny will be working together. What responsibilities will be hers during this time you're at home?
What characteristics are you looking for in a nanny?

INFORMATION FOR LIVE-IN APPLICANTS ONLY
Please describe the nanny's accommodations, your home, and your neighborhood.
Will a nanny be required to drive as part of her job? Please describe.
Is there are car available for the nanny to use during her work day? If yes, is it automatic or manual? Is the car a family automobile or is it specifically for the nanny?
If there is a car available for the nanny to use, is it available for her to use on evenings and days off? 
If the nanny brings her own car, how do you plan to reimburse her for insurance or gas if she uses it for errands and car pools?
Briefly describe those family activities in which you would include your nanny (i.e., meals, TV watching, outings, vacations, etc.) and those which you would keep separate.

INFORMATION FOR LIVE-OUT APPLICANTS ONLY
Does the nanny need a car in order to get to your home?
In miles, what is the distance from your home to public  transportation?
Distance to bus
Distance to MBTA
Distance to Commuter Rails
Will the nanny be required to drive as part of her job?
Is there a car available for the nanny to use during her work hours? If yes, is it automatic or manual?
If the nanny uses her own car for family errands, carpools, etc., how do you plan to reimburse her for gas/insurance?

REFERENCES

Please include two references for your prospective nanny to call, should she wish to do so. If you have had a nanny, please list him/her as one of the references.

Name:
Relationship:
Address & Phone Number:
Name:
Relationship:
Address & Phone Number:

Boston Nanny Centre was recommended to you by:

 

I understand that if I hire a nanny through Boston Nanny Centre I will be responsible to pay a placement fee to the agency. Upon receipt of my application Boston Nanny Centre will send me an employer/agency contract. I will print that contract and return a signed copy to the agency.


I have read the agreement above and by entering my initials in the box below, I agree to adhere to it.


( It may take up to one minute for your information to be submitted. Please be patient!)


Thank You!