Nanny Application

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Nanny Application

Complete the form below and we will contact you!
Use your computer's mouse to go to each box, sometimes tabbing does not work.
Alternatively, you can complete this printable form and fax it to us at: (713) 526-1463

PERSONAL INFORMATION
Legal Name:	Last	First	Middle
Home Address:	Number and Street	City	State and Zip Code
Phone:	Daytime	Cell Phone:
Email Address:
HIGHEST LEVEL OF EDUCATION--CHECK APPLICABLE
	GED
	HIGH SCHOOL
	SOME COLLEGE
	ASSOCIATE DEGREE	MAJOR
	UNDERGRADUATE DEGREE	MAJOR	MINOR
	MASTER'S DEGREE	MAJOR	MINOR
	DOCTORATE DEGREE	MAJOR	MINOR
	NANNY TRAINING COURSE	NAME OF SCHOOL
PROFESSIONAL EXPERIENCE-CHECK APPLICABLE
	NANNY		Yrs of Experience
	INFANT CARE SPECIALIST		Yrs of Experience
	GOVERNESS		Yrs of Experience
	TEACHER	Grade/Subject	Yrs of Experience
	TUTOR	Grade/Subject	Yrs of Experience
	NURSE	Department	Yrs of Experience
	BABYSITTER		Yrs of Experience
	NURSERY WORKER		Yrs of Experience
	YOUNGER SIBLINGS	Explain:
	MOTHER/GRANDMOTHER	Explain:
	CHILD RELATED STUDIES	Explain:
	CAMP COUNSELLOR	Explain:
	AFTER SCHOOL PROGRAM	Explain:
	INSTRUCTOR (dance, swimming, art, etc.)	Explain:
	OTHER EXPERIENCE	Explain:
CERTIFICATIONS AND LICENSES
	INFANT AND CHILD CARE CPR
	FIRST AID
	TEACHER'S CERTIFICATION
	NURSE'S LICENSE
	NANNY CERTIFICATION
	GOVERNESS CERTIFICATION
	OTHER	Explain:
CONTINUING EDUCATION
	COMMUNITY COLLEGE	Courses:
	LEARNING CENTER	Courses:
	AFFILIATED WITH LOCAL NANNY GROUP
	AFFILIATED WITH NATIONAL/INTERNATIONAL NANNY GROUP
	OTHER	Explain:

DO YOU HOLD A CURRENT DRIVER'S LICENSE?
DO YOU HAVE YOUR OWN VEHICLE?
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
ARE YOU SEEKING A FULL TIME LIVE OUT NANNY POSTION?
ARE YOU SEEKING A FULL TIME LIVE IN NANNY POSTION?
ARE YOU SEEKING A PART TIME POSITION?
IF PART TIME, WHAT IS YOUR AVAILIBILITY?			Explain:
OTHER:	Explain:
WHAT IS YOUR GROSS SALARY REQUIREMENT? CHOOSE ONE OR MORE OF THE FOLLOWING:
Annually	Amount:
Weekly	Amount:
Hourly	Amount:
ADDITIONAL INFORMATION THAT YOU WOULD LIKE US TO KNOW:

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