Family Application

Are There Any Smokers In Your Household:

Yes

No

Child 3 - Date of Birth:

Desired Nanny Hours on Tuesday

Desired Nanny Hours on Sunday

The information provided in this document is accurate to the best of my knowledge.

Please Select the desired amount of Child Transportation:

Daily

Weekly

On Occasion

None

Will you Require your Nanny to go on Vacation with you?

Yes

No

It's a Possibility

Cell Phone 2:

Is this a Live-In Position?

Yes

No

Maybe

Child 2 - Full Name:

Number of Nannies Your Family Has Had In The Last 5 Years:

Address:

Please select all responsibilities you will require your Nanny to perform, aside from child-care:

Light Housekeeping / General Pick-Up

Errands

Family Cooking

Grocery Shopping

Purchase Gifts

Ironing

Children's Laundry

Family Laundry

Parent 2 Employer Phone:

Would you Consider Sharing a Nanny?

Yes

No

It's a Possibility

Child 1 - Full Name:

Previous Child Care References:

Employer Phone:

What level of childcare experience do you prefer?

2 - 3 Years Minimum

4-6 Years Minimum

6-10 Years Minimum

10+ Years Experience

Child 1 - Date of Birth:

The information provided in this document is accurate to the best of my knowledge.

How Did You Hear About Us?

Desired Nanny Hours on Saturday

Child 3 - Gender:

Male

Female

Child 4 - Full Name:

Desired Nanny Hours on Thursday

Please include a family photo on your account

Desired Nanny Hours on Monday

Parent Employer:

Home Phone Number

Will Occasional Overnight Stay be Required?

Yes

No

It's a Possibility

Parent Name

Child 2 - Gender:

Male

Female

Desired Nanny Hours on Wednesday

Cell Phone:

If yes, Can you Please Describe Accommodations:

Family Interests and Activities:

Desired Nanny Hours on Friday

Child 3 - Full Name:

Please list your preferred start date

Parent 2 Name

Child 2 - Date of Birth:

Child 4 - Gender:

Male

Female

Type of Pets:

Child 4 - Date of Birth:

Child 1 - Gender:

Male

Female

Housekeeping Standards:

Needing Assistance

Average

Neat & Orderly

Meticulous

Parent 2 Employer:

Email 2:

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Please Describe an Average Day, Including Household Duties, Which your Nanny Would Encounter:

Preferred Nanny Salary

$15.00 - $16.00

$16.00 - $18.00

$18.00 - $20.00

$20.00 - $22.00

Email:

Would you be Interested in a Nanny with their own Child to Accompany them?

Yes

No

it's a Possiblity

​Above & Beyond Nanny Services, Inc.

Above & Beyond Nanny Services, Inc.