Family Application

Are There Any Smokers In Your Household:

Yes

No

Child 3 - Date of Birth:

Desired Nanny Hours/ Times on Tuesday

Desired Nanny Hours/ Times 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 is 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:

Street 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 is 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:

City, State, Zip code:

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

How Did You Hear About Us?

Desired Nanny Hours/ Times on Saturday

Child 3 - Gender:

Male

Female

If yes, Can you Please Describe Accommodations:

Child 4 - Full Name:

Desired Nanny Hours/ Times on Thursday

Please include a family photo on your account

Desired Nanny Hours/ Times on Monday

Parent Employer:

Home Phone Number

I approve the information provided in this document to be shared with potential candidates

Yes

No

Will Occasional Overnight Stay be Required?

Yes

No

It is a possibility

Parent Name

Child 2 - Gender:

Male

Female

Desired Nanny Hours/ Times on Wednesday

Cell Phone:

Please Indicate Your Salary Range:

Family Interests and Activities:

Desired Nanny Hours/ Times 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:

Check here to receive email updates

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

Email:

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

Yes

No

It is a possibility

​Above & Beyond Nanny Services, Inc.

Above & Beyond Nanny Services, Inc.