Name
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First Name
Last Name
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
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(###)
###
####
Email
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Neighborhood name:
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How can we reach you?
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What type of placement are you in need of?
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Anticipated start date or day of event
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MM
DD
YYYY
Child(ren) Name(s), Age(s), and Date of Birth:
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Any Children with Special Needs, Medical Conditions or Food Allergies?
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Please let us know if there are any vaccines you would require of the caregiver:
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(ie flu, TDAP, etc.)
Give a discription of your family. What are you like as individuals and as a family? What do you like to do as a family and anything else that helps for someone to want to work for you.
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Please describe your parenting style:
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Parent(s) Occupation(s)
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Please share if your child/ren need to be taken to activities or school.
Describe household tasks your nanny will be expected to perform.
What days do you need a nanny to work?
Hourly Rate
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Compensation will depend on both your preferences and the candidate's preferences. For optimal results, we suggest using a nanny or domestic payroll service, and we'd be happy to connect you with one. Please be aware that we do not oversee how you pay your nanny; our role is to provide the tools and resources to help you make informed decisions. As a referral and placement agency, we emphasize the importance of appropriately compensating your nanny.
Guaranteed hours per week needed?
It is industry standard that the nanny gets guaranteed hours when hiring part time or full time
Do you have pets in your home?
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If yes to pets, please share what kind and how many and will the nanny be expected to help with pet care?
Will the Nanny Have Paid Holidays Off?
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Yes
No
Benefits offered please check all that apply.
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Please note some industry standards include two weeks paid vacation, stipend towards medical benefits, sick days, paid holidays
Have You Had a Nanny Previously?
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Yes
No
Describe Any Personality Traits You Are Looking For
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Do You Have Any Other Household Employees?
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Yes
No
Do You Have a Pool On Your Property?
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Yes
No
Will you need a nanny to travel with your family or do overnights? If yes, please explain in more detail:
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Does Either Parent Work From Home or is a Stay at Home Parent? If yes, please explain.
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Do you have cameras in your home?
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Additional Comments:
How did you hear about North Hills Nanny LLC.?
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North Hills Nanny LLC. does not discriminate on the basis of race, color, national or ethnic origin, ancestry, age, religion or religious creed, disability or handicap, sex or gender, gender identity and/or expression, sexual orientation, military or veteran status, genetic information, or any other characteristic protected under applicable federal, state or local law. We encourage our families to follow Equal Employment Opportunity practices when interviewing and selecting candidates for their positions.*
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