Baby Nurse Application

Where do you currently live? *

New York:

Manhattan
Brooklyn
Queens
Bronx
Staten Island
Westchester
Long Island

New Jersey:

New Jersey

Connecticut:

Connecticut

I'd like to work:

24 hour care
Nights only
Days only

Do you drive?

Yes
No

Contact Information

Full Name: *:

Address:

City, State, Zip:

Home Phone Number:

Cell Phone:

Email Address: *:

Please tell us how you heard about Absolute Best Care Agency:

Please provide us with the name of the source:

REFERENCES:

(Please write in boxes provided below, start with the most recent position):

Dates:

Parent Full Name 1:

Parent Full Name 2:

Address:

City, State:

Contact Numbers

Home:

Work:

Cell:

Type of Care:

24 hours
Daytime
Nighttime

You Cared For:

Single
Twins
Triplets

How old was infant:

Boy
Girl
Both

Were there other children in the home?

Yes No

Daily Rate:

How did you get this position?

Reference 2:

Education

Level of Education:

Name of School:

Are you currently attending college? If so, please explain:

Certifications

Infant CPR:

Expires:

First Aid:

Expires:

Please list any additional certifications including expiration dates:

Specialized Training

Newborn Care Specialist ‘Baby Nurse’ Class:

Approx date of class:

Location & Name of Training:

Please describe any child related courses or specialized training you have taken:

How many Baby Nurse assignments have you completed?

Would you work in a household with dogs?

Yes No

Would you work in a household with cats?

Yes No

Have you ever worked with twins?

Yes No

Have you ever worked with triplets?

Yes No

Baby Nurse Responsibilities

Responsible for all aspects of infant care

Pre and post delivery guidance and advice

Educating parents on infant care

Monitor baby's nutritional intake and track wet and soiled diapers

Move infant towards a sleeping & eating pattern

Breastfeeding support and assistance

Umbilical & circumcision care

Sponge and tub bath

Night care – wake up at night with baby

Sibling interaction

Infant’s laundry & bottle sterilization

Organize and keep nursery clean

Provide smooth transition into parenthood

Additional Information

What other languages do you speak FLUENTLY (besides English)?