Nanny Application
General Information:
· Name
· Address
· Home #
· Alternate #
· Email Address
· Birth date
· Are you eligible to work in the US
· Salary Requirements
Educational Background:
· High School Degree or GED
o High School Name
o High School City, State
· College Degree
o College Name
o College City, State
· Other Training:
o CPR
o 1st Aid
o Experiences with special needs children
o Swimming
o Other
· Any languages in addition to English?
Child Care Work Experience:
· Job Title/Company
o Address
o Supervisor name & Phone #
o # & ages of children cared for (if applicable)
o Dates worked
o Hours worked
o Starting and ending salary
o Reason left
· Job Title/Company
o Address
o Supervisor name & Phone #
o # & ages of children cared for (if applicable)
o Dates worked
o Hours worked
o Starting and ending salary
o Reason left
· Job Title/Company
o Address
o Supervisor name & Phone #
o # & ages of children cared for (if applicable)
o Dates worked
o Hours worked
o Starting and ending salary
o Reason left
· Job Title/Company
o Address
o Supervisor name & Phone #
o # & ages of children cared for (if applicable)
o Dates worked
o Hours worked
o Starting and ending salary
o Reason left
· Job Title/Company
o Address
o Supervisor name & Phone #
o # & ages of children cared for (if applicable)
o Dates worked
o Hours worked
o Starting and ending salary
o Reason left
References:
· Name
o Relation
o Contact Info
· Name
o Relation
o Contact Info
· Name
o Relation
o Contact Info
Background & Experience:
· What was your favorite nanny position and why?
· Why did you become interested in this type of work?
· Do you know 1st aid? Have you ever had to use it?
· Have you had CPR training? Child/infant CPR training?
Caregiver Personality:
· What do you see as your greatest strength in working with children?
· What is your greatest weakness in working with children?
· Do you consider yourself prompt and reliable?
· What do you believe makes a happy child?
· What are your future goals?
· Do you smoke?
· Do you have any visible tattoos or piercings?
Caregiver/Child Relationship:
· What types of things do you like to do with children?
· Give examples of types of activities that are age-appropriate for a _____yr-old.
· Have you ever toilet-trained a child?
· How do you enforce rules?
· How do you handle a child who misbehaves?
· How do you feel about caring for a sick child?
· How do you feel about caring for a special needs child (if applicable)?
Caregiver/Parent Relationship:
· How do you prefer to communicate with the parents?
· How receptive are you to direction & criticism?
· Have you ever had any problems with previous employers? If so, what were they and how were they resolved?
Additional Notes: