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Are you interested in becoming a babysitter or nanny? We would love to hear from you! Please �ll out this application once you get it back to us we will contact you within 24-48 hours to set up an interview!
My name is Phone Number Email addressEmergency contact Current address How long at current address Previous addressHow long at previous address
** Please submit a current headshot picture of yourself. If you cannot submit one at this time, one will be taken during the interview.
Please enter your current and past childcare jobs. The more jobs you list, the better. We will call your employ-ers to check references.
Employer Name and Address
Home phone Work phone
Dates of Employment
How many hours per week Rate of pay
Number of children as well as ages of children
Duties
Reason for leaving
Additional information about this job?
Nanny Application
Pg 1Nicole Torres - Ph 805-835-1107 - [email protected]
Employer (2) Name and Address
Home phone Work phone
Dates of Employment
How many hours per week Rate of pay
Number of children as well as ages of children
Duties
Reason for leaving
Additional information about this job?
Employer (3) Name and Address
Home phone Work phone
Dates of Employment
How many hours per week Rate of pay
Number of children as well as ages of children
Duties
Reason for leaving
Additional information about this job?
Pg 2Nicole Torres - Ph 805-835-1107 - [email protected]
Areas you can work In? (Circle city)
Paso Robles Creston San Miguel Templeton
Shandon Templeton Atascadero Santa Margarita
Pismo Beach Cambria Morro Bay Cayucos
Shell Beach SLO Lompoc Los Osos
Santa Maria Arroyo Grande Avila Beach Grover Beach
Harmony Nipomo San Simeon
Employment Position (Circle)
Type: Part Time Full Time
Live - In Live - Out
Can Travel Yes No
Housekeeping Yes No
Previous Childcare Experience? (Check box)
Ages Childcare 0-6 months Live-in nanny 6-12 months Live-out nanny 1-3 years Pre-school 3-6 years Teacher 6-12 years Babysitting Twins/Triplets Day Care
Other childcare experience
Pg 3Nicole Torres - Ph 805-835-1107 - [email protected]
Maximum number of children you will care for at one time and age range of children most comfortable with?
Do you have experience working with any special needs children? If so, please explain.
Check items you will perform or are open to negotiate with the family? Prepare child meals Change child bed linen and laundry Iron child clothes Make child beds Clean child bathrooms Dust/vacuum child rooms Wash family dishes Change family bed linen and laundry Iron family clothes Make family beds Clean family bathrooms Dust/vacuum rooms Prepare family meals Shop for groceries Feed/walk pets Place Trash at curb Arrange children appts. Drive child to activities
Are you able to prove US citizenship? Yes NoHave you ever been convicted of a crime? Yes NoIf Yes, Explain? Do you own a car? Yes No If you don't have a car how will you get to work? Do you have car insurance? Yes No Have you ever been known by another name? Yes No (If yes) How long of a commitment are you willing to make to a family?
Expected salary? Distance willing to commute? Are you willing to do temporary jobs? Yes No
Pg 4Nicole Torres - Ph 805-835-1107 - [email protected]
Other Certi�cates:Languages: Musical Instrument: ECE credits: First Aid : Lifesaving/Water Safety: CPR: If not CPR or �rst aid certi�ed, are you willing to? Yes No Any reason to restrict full activity regarding childcare? Do you smoke? Yes No Would you be willing to undergo drug screening? Yes No
Education
School Name /Location Degree Year
High School
College
Graduate/ Ph D
To the best of my knowledge, the above information is accurate.
Print Name
Signature Date
Pg 5Nicole Torres - Ph 805-835-1107 - [email protected]
