Nanny Application for Employment

Institution

Last Grade
Completed

Area of Study

High School

Trade School

Other Courses

Please fill out the form below

Name:

Date:

Home Address:

City

Zip Code

Phone: home

work

cell

Email Address:

Preferred areas for employment:

Are you eligible to work in the U.S.?

How were you referred to Babies to Boomers?

Type of position you are seeking (check as many as apply):

Permanent Full-time Days Weekends 24 Hour/Overnight

Temporary Part-time Evenings Live-in Work around school schedule

Days/ Hours Available:

Do you have an insured, reliable vehicle?

In case of emergency, please contact:

Phone:

Relationship to you:

EDUCATION:

Have you had CPR?

Expiration date:

1st aid?

Exp. date:

Have you taken Child Development courses?

Have you taken any Education classes?

Home Economics classes?

PERMANENT CHILD CARE EXPERIENCE: Please list jobs of 3 months or more, i.e. nanny, day care, teaching, etc.

	Dates	Employer & Supervisor	Address	Home/Office Phone	# of Children/Ages
1.
Reason for leaving:				Gross Salary
2.
Reason for leaving:				Gross Salary
3.
Reason for leaving:				Gross Salary
4.
Reason for leaving:				Gross Salary

BABYSITTING EXPERIENCE: Please list babysitting experience of 3 months or more, NOT including family members.

	Dates	Parent(s) Name	Address	Home/Office Phone	# of Children/Ages
1.
2.
3.
4.

CHARACTER REFERENCES: People who know you well. NOT work references

	Name	Address	Home/Office Phone	Length and Nature of Relationship
1.
2.
3.

VOLUNTEER WORK: Please list dates and organizations.

1.
2.
3.
4.

OTHER WORK EXPERIENCE: Please list your most recent jobs NOT in the child care field

	Dates	Company	Supervisor/Reference	Daytime Phone	Reason for Leaving
1.
2.
3.
4.

Clubs, Professional Associations, Organizational Affiliations:

1.
2.
3.
4.

PERSONAL ESSAY Why do you feel you would make a good nanny? Please include special skills, activities you like to do, special interests, and details about your personality. This is the first impression a family will have on you, so please take some time to think about what you would like to say. Address it as a letter to the family.

Please answer the following questions as completely as possible.

1. What types of stimulating activities would you do with a 6 month old to promote growth and development?

2. What activities would you include in a typical day if you were caring for a two-year-old? What types of things would you be teaching this child?

3. What would you fix a two-year-old for lunch?

4. What would you do if two children ages 5 and 3 began fighting over a toy?

5. What would you do if a child felt hot and seemed sick when she woke up from a nap?

6. How would you handle a child who is going through a biting stage?

7. How would you handle a temper tantrum?

8. How do you handle a child who screams when the parents get ready to leave?

9. List some reasons why a baby might cry.

10. If you can not find anything wrong, what are some ways to soothe a crying baby?

11. Do you have experience with special needs children? If so, please describe.

12. Please describe your child care philosophy regarding discipline. What methods would you use with specific ages?

13. What would you say to a 3 year old who tells you she hates you?

14. How often should a newborn's diaper be checked?

Authorization

I understand that the information on this application has been requested for the purpose of evaluating my qualifications for employment by parents, as a child care provider. I also understand that I am not, and will not be an employee of Babies to Boomers.
I hereby authorize you to request reference checks which may include information on my character, education, driving record, police record, past employment, previous addresses, social security number, and credit history.
To the best of my knowledge, the information on this application is true. I understand that misrepresentation or omission of facts in connection with the information provided may be sufficient cause for dismissal wherever discovered.
I permit Babies to Boomers to show this application and all references to parents as a part of the evaluation process.
I agree to release, and hold Babies to Boomers harmless for any act of the employer. I also agree to hold Babies to Boomers harmless of any claim as a result of the placement.

NOTICE: We will be requiring criminal, driving, and child abuse screenings. We will also require a credit check, Social Security check, or further screening requested by a family.
DISCLAIMER: There is no guarantee of employment. We reserve the right to reject any candidate.


Applicant's Signature	Date

Disclosure

This document serves solely as a clear and conspicuous written disclosure as required by the Federal Fair Credit Reporting Act set forth in section 604 (b) to the Candidate that previous employment, education, social security, credit, motor vehicle report and criminal background check may be obtained for the purpose of this “Application” only.

By the signature below, the “Applicant” acknowledges that Babies to Boomers has made this disclosure.


Applicant's Signature	Date