Loving Nannies Family Application

Family Name

First

Last

Email

Home Phone

Cell Phone

Work Phone

Home Address – Street

Appt / Suite No

City

State

Zip Code

Occupation

Does either parent work from home?

Yes

No

If Yes

Full Time

Part Time

Please list the name and age of all your children

Do you have children with special needs?

Yes

No

If yes, please explain

May we email you candidate profiles?

Yes

No

May the candidates call you?

Yes

No

When are you looking for your nanny to start?

Please check all days that are needed for the job

Mornings, evenings, or both? Specific times?

What type of domestic help are you looking for? (check all that apply)

What pay rate are you offering? (Nannies typically require a 3-4 hr. minimum)

Do you provide any benefits for the nanny? Yes or No If so, please list below: (Paid vacation, sick days, health insurance, paid holidays, 2 weeks notice etc…)

Do you require the nanny to drive?

Yes

No

Do you have a vehicle for the nanny to drive?

Yes

No

If yes, will you provide gas allowance?

Yes

No

Will they be driving to/from school and activities?

Yes

No

Please list all schools and activites your children attend.

Do you require the nanny to speak clear and fluent English?

Yes

No

Additional languages?

Yes

No

If Yes, please explain

Specific age range you are looking for?

Do you require the nanny to have specific credintials?

Yes

No

If yes please explain

Please check one

Heavy housekeeping

Light housekeeping

None

Please explain housekeeping expectations

Please describe your family’s lifestyle, interests and activities

If requesting a live-in nanny, please describe living accommodations

If job is live-in, can she go home on her days off?

Yes

No

Do you require nanny to run errands?

Yes

No

Please explain errands

Do you require the nanny to travel?

Yes

No

Is a passport required?

Yes

No

Do you have a pet?

Yes

No

Describe pet/pets

Anything else you would like to tell us that will help us find you the perfect nanny…

Active dury, retired military and repeat clients, check for a 10% discount

Loving Nannies Service Agreement

I agree to Loving Nannies Service Agreement (please click link below, read agreement, and check box prior to proceeding)

Loving Nannies Service Agreement

Electronic Signature

I hereby irrevocably agree to the terms and conditions of this agreement as provided in the following Service Agreement.

Date

Loving Nannies Family Application

Orange County/Los Angeles Family Application and Agreement

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