Personal
Information |
| Last Name: |
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M.I.:
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First Name: |
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| Current Address: |
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| City: |
State:
Zip:
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| Previous Address: |
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| Previous City: |
State:
Zip:
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| Phone: |
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| Cell Phone: |
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| Email: |
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| Date of Birth: |
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| US Citizen? |
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| Marital Status: |
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| Highest level of education
completed: |
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| Languages you can speak other
than English: |
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| Have you ever been convicted
of any crimes? |
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| Have you ever received a traffic
violation? |
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| Are you allergic to any animals? |
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| Do you swim? |
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| Do you smoke? |
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| Are you on any medications? |
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| What is your religious preference? |
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Work
History & Qualifications |
Please list
your last three (3) jobs in the spaces below: |
| Previous Job 1: |
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| Previous Job 2: |
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| Previous Job 3: |
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Please
list any hobbies and/or strengths that you think may help you
in finding a family: |
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Why did you choose to
become a nanny? |
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What makes you a
good nanny? |
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What qualifications do
you have to be a nanny? |
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| Are you CPR Certified? |
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| Are you First Aid Certified? |
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Please
list three (3) references in the spaces provided below: |
| Reference 1: |
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| Reference 2: |
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| Reference 3: |
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What
are you looking for in a job? |
| What area do you wish to work
in? |
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| What type of position are you
looking for? |
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| When will you be available
to start? |
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Please list the days and
hours you are available: |
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| What type of salary do you
wish to make? |
per
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| What age children do you prefer? |
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Nanny Agreement
By typing in your name below and submitting this application, you understand and agree to the following terms:
- All information that is given is true and accurate.
- I agree to allow Five Star Nannies, LLC to perform a criminal background check and obtain my driving record.
- If any information in this application is false or otherwise incorrect, I could be dismissed immediately
without any further obligation from the employer or Five Star Nannies, LLC.
- This information can and will be used for hiring by a potential employer.
- I understand that Five Star Nannies, LLC is not responsible nor liable for any acts that are initiated by me, being the employee or
potential employee, or the employer.
- I agree not to hold Five Star Nannies, LLC responsible for any or all claims, including any court costs or attorney fees that may
arise, incurred by person arising out of my employment.
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| Type your full name here: |
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