All About Nannies - Family Application

Family Information
Family Last Name: Home Phone:
Resident Address: City: Zip:
Major Cross Streets: Email Address to email nanny profiles to:

Mother's/Father's Name: Cell Phone:
Work Place: Occupation: Work #: Fax #:
Work Address: City: Zip:

Father's/Mother's Name: Cell Phone:
Work Place: Occupation: Work #: Fax #:
Work Address: City: Zip:

Child's NameAgeBoy / GirlDate of BirthActivitiesPersonality (Energetic, Shy,..)
Do you currently have a nanny that you are replacing? Are we able to call the home during the day?
Are there any children taking medications or under serious medical care (allergies)?

Nanny Criteria
Live In or Live-Out Full-Time or Part-Time Undecided Schedule but Mostly Wanting
Days and Times Needed Major Holidays Paid Off? Yes or No Start Date
Paid Vacation Days Paid Sick Days Hourly Rate Do you require a non-smoker? Will there be a stay at home parent?
For Live-In Nannies, Please describe the Living Quarters:
Will Driving Be Required: Will a car be provided: Would be willing to contribute towards health insurance? If so, what amount?

Family Information
Describe your Family's Lifestyle (Formal, Casual, Fast paced...)
What kind of Child Care are you currently using?
Are there any pets in the house (if so, please list them):
Do you have a swimming pool? If so, is the door self-closing?
Does anyone smoke in your home (inside or outside) ? Are there any weapons in the house (if so, what kind and are they locked up)?
What languages besides English are spoken in the home?
Describe your ideal nanny:
Describe a typical day for the nanny:
Nanny Characteristics - please list important qualities you feel the nanny should possess:
Please describe your family's philosophy on child rearing

Specify Any Other Nanny Needs:
Cooking for children Grocery shopping Tutoring Feeding Pets Other:
Children's Laundry Driving Lt. Housekeeping Running Errands

Please keep in mind that the Nanny's first priority is the care and well-being of the children, so we do ask that you try to make other additional Nanny needs as light as possible so as to not cause an overburden on the Nanny caring for your children.

General Information:
Are there any hidden cameras in the home currently or in the future?
Are you working with any other agencies? If so, which one(s)?

Our Marketing Department would like to know how you heard about us:
International Nanny Association
Phoenix Sun, Arizona Cardinals
Referral: (Please list individual's name)
Internet (Please pick one): Yahoo Google AOL MSN/Bing Other Directory / Search EngineKeywords Used:

Industry Standard - For vacation / sick / personal is 10 days per year for a Full-Time Nanny. The family decides if they want to offer this after 3 months, 6 months, or 9 months of employment. Please pick when you will be offering benefits. Major Holidays Paid Off. Follow the IRS Code for gas mileage reimbursement if they are taking the children in the nanny vehicle. Some families offer birthday paid off and the day after Thanksgiving as an extra perk.

Health Insurance: Knowing how important it is for you to have a healthy nanny you may wish to negotiate this during the interview process. Part-Time Nannies are normally offered half of the above benefits and are ultimately your decision.

"I have filled out the following form to the best of my knowledge, and I believe everything to be as accurate as possible. I understand I will receive a follow-up call from a representative of All About Nannies and will be asked to provide a credit card number as well as sign additional terms and conditions."

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