Nanny/Housekeeer Application - Nanny Smart Search

New York:

Manhattan
Brooklyn
Queens
Bronx
Staten Island
Westchester
Long Island

New Jersey:

New Jersey

Connecticut:

Connecticut

Seeking placement as:

Housekeeper
Nanny

I'd like to:

Live-in
Live-out

Contact Information

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

Please provide us with the name of the source:

Driving Information

Do you drive? Yes No

Driver's License Number

State Issued

Do you own your own car? Yes No

Make/Model and Year

Do you have motor vehicle violations including car accidents and tickets? YesNo

Please explain

REFERENCES:

Start (Month Year) End (Month Year)

Was this job Live in, Live out?

Live-in Live-out

How did you get this position?

How many children in family?

Age of children at start of position:

Schedule:

Days Worked (ex: M-F):

Start time:

Finish time:

House Detail:

Number of bedrooms:

Number of bathrooms:

ADD Reference 2:

Please explain any gaps in employment:

Start (Month Year) End (Month Year)

Education

Name of Grad School:

Grad School Field of Study:

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

Certifications

First aid:

Expires:

Specialized Training

Newborn Care Specialist ‘Baby Nurse’ Class:

Approx date of class (Month Year):

Location & Name of Training:

Special Needs experience

Have you ever worked with a child with autism?

Have you ever worked with a child with other Special Needs?

Job Preferences

Desired salary per hour:

per week:

I want:
  Full time
  Part time (full work days, just less than 5 days/week)
  Mornings (job ends BEFORE 3pm)
  Afternoons (job starts AFTER 1pm)
  Weekends (I can commit every weekend)

Please select days you can work:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Can you start a job at 7:30am or earlier?

Yes No

Can you go with a family to the Hamptons as a 'live in' Mon-Fri for 4 to 8 weeks during the summer?

Yes No

Would you work in a household with dogs?

Yes No

Would you work in a household with cats?

Yes No

Can you swim?

Yes No

Have you ever worked in a Kosher home?

Yes No

Have you ever worked with twins?

Yes No

Have you ever worked with triplets?

Yes No

Did you have any Childcare (Nanny) Responsibilities?

Yes No

Childcare (Nanny) Responsibilities

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

Maintain proper eating and sleeping patterns

Prepare all meals for children

Encourage cognitive and motor development and self-help skills

Organize and supervise playdates

Take children to and from school and activities

Take children to museum, library, zoo

Potty training

Driving children to/from activities and/or school

Teach child a second language

Homework assistance

Played sports with children

Walked the dog

Fed the dog/cat

Care for Special Needs

Children's laundry

As a nanny are you willing to do housekeeping other than for the children?

Yes No

Housekeeping Responsibilities

Dust, mop, sweep, vacuum and clean floors

Kitchen cleaning

Cleaned appliances (refrigerator, oven, appliances)

Bathroom cleaning (Showers, floors, toilets, counters)

Care for fine objects and furnishings

Polish silver

Bedrooms (dust, clean floors)

Make beds daily

Family laundry

Change all linens and towels

Ironing (clothes, shirts, etc..)

Iron curtains and/or sheets

Cooking for family

Meal prep (salads, vegetables)

Grocery shopping for family

Walked the dog

Fed the dog/cat

Run errands as requested

Additional Information

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

What skills do you possess that will make you a good caregiver?

Please provide us any additional information about yourself that will assist us in making the best placement for you?

Where do you currently live? *

Contact Information

REFERENCES:

Please explain any gaps in employment:

Education

Certifications

Specialized Training

Special Needs experience

Job Preferences

Childcare (Nanny) Responsibilities

Housekeeping Responsibilities

Additional Information