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Nanny Application
Nanny Application Form

Security Information

Thank you for taking the time to complete this application. Before you begin, you may want to print a blank copy of the application as a safeguard in the event that you run into any problems with your computer during the process. The application may take as long as 45 minutes to complete and some nannies have informed us that their internet provider has "timed them out" prior to completing it. Should that occur, you can complete the application hard-copy and mail it to us at: Professional Nanny Online, 46 West Central St., Natick, Ma. 01760. We look forward to helping you find a job you'll love!

When you have finished completing this form, be sure to press the "Submit" button. Thanks


To complete an On-Line Training Application ONLY, Please Click Here.
Otherwise, complete the following application in full!

Note: All required fields are highlighted in blue!
Please do NOT use all CAPITAL LETTERS!

Last Name:
First Name:
MI:
Street Address:
 City, State & ZipCode:
Telephone (Days):
 Telephone (Evenings):
Social Security #:
Citizenship:
 Sex:
Emergency Contact #1:
(Name, Address, Phone)
 Date Available to Start:
Year: Month: Day:
Emergency Contact #2:
(Name, Address, Phone)
 Your Date of Birth:
Year: Month: Day:
E-mail address:
(ex. user@aol.com)
 Fax Number:
(optional)
CommuteTime:
 Area/State You Wish To Work:
How Did You Hear Of Us?
 Cell-Phone/Pager Number:
(optional)
Do you wish to participate in
our On-Line Training Program?

Call our office at (508) 650-8889 for
details and more information.

Section A

How many children are you comfortable working with:
Are you accessible to the T (MA only):
Do you smoke?
Do you have experience at a daycare?
Do you have experience as a Nanny?
Do you have a good work history?
Do you have 1 year of Child-Care Experience?
Do you have Infant child-care experience:
Do you have Toddler child-care experience:
Do you have Pre-school child-care experience:
Do you have School-age children experience:

Do you prefer FT or PT:
Which do you prefer, Live-In or Live-Out:
If you chose Live-In, what is your pay range:
If you chose Live-Out, what is your pay range:
Do you use a Nickname:
Do you drive a Car:
Do you have a criminal record?
Do you have a good driving record?
Do you own your own car?
Are you able to drive a standard?
Do you have swimming ability?
Are you a High school grad/GED?
Any education after High school?
Do you have CPR Certification?
Do you have First-Responder Certification?
Do you have any children of your own:
Length of service committment:
Do you need to bring your own child:
What is your hair color:
What is your eye color:


Availability Schedule

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Hours:
Hours:
Hours:
Hours:
Hours:
Hours:
Hours:



In the fields below, please provide an explanation if any of these situations apply to you:
Motor vehicle infractions, any loss of license or non-moving violations.
If you were employed less than one year at your last two jobs.
If you have left any job on un-friendly terms.
Please explain any gap in your employment history.


In addition to child-care duties, families may request some other household tasks. Please indicate which tasks you are willing to perform:
Laundry Grocery Shopping Driving Errands
Dusting Vacuuming Bathrooms Family Meal Prep


Do you like pets? Would you be comfortable in a home w/pets?
Please indicate any specific kinds of pets you would not be comfortable working with:


Have you considered one or more of the following careers:
Social Work Nanny Teaching Police Work
Nursing Day-Care Sales Ministry


When caring for children there are a number of activities that require your attention. Please rate the following activities:
(1 for Most Enjoyable and 5 for Least Enjoyable)
Reading to children Watching TV Arts & crafts
General supervision Outdoor play Bathing
Feeding Dressing children Cooking
Board games Day trips Family outings
Tidying up after children Make believe games


Section B
Child Care Experience

Please list each employer, Start with most recent first:

Family or Company Name: From: To:
Address: City: State, Zip Code:
Telephone:
Ages of children:
Please Indicate your Responsibilities as related to this job:
feeding meal clean-up bathing meal prep
car-pool grocery-shopping laundry errands
homework help overnight care reading games
plan activities special projects driving other
Please briefly explain your reason for leaving:

Family or Company Name: From: To:
Address: City: State, Zip Code:
Telephone:
Ages of children:
Please Indicate your Responsibilities as related to this job:
feeding meal clean-up bathing meal prep
car-pool grocery-shopping laundry errands
homework help overnight care reading games
plan activities special projects driving other
Please briefly explain your reason for leaving:

Family or Company Name: From: To:
Address: City: State, Zip Code:
Telephone:
Ages of children:
Please Indicate your Responsibilities as related to this job:
feeding meal clean-up bathing meal prep
car-pool grocery-shopping laundry errands
homework help overnight care reading games
plan activities special projects driving other
Please briefly explain your reason for leaving:

Family or Company Name: From: To:
Address: City: State, Zip Code:
Telephone:
Ages of children:
Please Indicate your Responsibilities as related to this job:
feeding meal clean-up bathing meal prep
car-pool grocery-shopping laundry errands
homework help overnight care reading games
plan activities special projects driving other
Please briefly explain your reason for leaving:

Family or Company Name: From: To:
Address: City: State, Zip Code:
Telephone:
Ages of children:
Please Indicate your Responsibilities as related to this job:
feeding meal clean-up bathing meal prep
car-pool grocery-shopping laundry errands
homework help overnight care reading games
plan activities special projects driving other
Please briefly explain your reason for leaving:

Family or Company Name: From: To:
Address: City: State, Zip Code:
Telephone:
Ages of children:
Please Indicate your Responsibilities as related to this job:
feeding meal clean-up bathing meal prep
car-pool grocery-shopping laundry errands
homework help overnight care reading games
plan activities special projects driving other
Please briefly explain your reason for leaving:

Section C
Non-childcare employment

Begin with most recent, list all non-child care work:

Company Name: From: To:
Address: City: State, Zip Code:
Telephone Numbers:
Contact Name:
Please indicate your responsibilities as related to this job:

Company Name: From: To:
Address: City: State, Zip Code:
Telephone Numbers:
Contact Name:
Please indicate your responsibilities as related to this job:

Company Name: From: To:
Address: City: State, Zip Code:
Telephone Numbers:
Contact Name:
Please indicate your responsibilities as related to this job:

Company Name: From: To:
Address: City: State, Zip Code:
Telephone Numbers:
Contact Name:
Please indicate your responsibilities as related to this job:

Section D
Personal Overview

Please do NOT use all CAPITAL LETTERS!
Also, DO NOT USE the "Return" or "Enter" keys at the end of each line.
Only use the "Return" or "Enter" keys for a paragraph break.

1) Please describe your family:

2) Please tell us how the child you care for will benefit from having you as their Nanny:

3) Please tell us how your friends might describe you:

4) Please tell us how you might respond in a stressful situation:

5) Please describe your strengths and any creative hobbies you will bring to your job:

6) Finally, Please tell us why you would like to be employed as a Nanny:

Section E
Educational Background

School Attended:
Address: Course of Study:
From: To: Did you graduate?: Degree:

School Attended:
Address: Course of Study:
From: To: Did you graduate?: Degree:

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School Attended:
Address: Course of Study: