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Recurring Care: Family Application
We are excited to assist your family with securing care!
This application will assist us in vetting appropriate candidates for your position.
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* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
Today's Date
*
MM
/
DD
/
YYYY
Physical Address (address, city, state, and zip code)
*
Your answer
Phone Number
*
Your answer
We are looking to fill the following role
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Nanny
Household Manager
Home Educator
Tutor
Date Night
Personal/Administrative Assistant
Housekeeper
Personal Chef
Night Nanny
Postpartum Support
Other:
Required
This position is
*
Full-Time
Part-Time
Temporary/Occasional
Date Night
Event Care
Other:
We anticipate needing services
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Short-Term (12 months or less)
Long-Term (1 year or more)
Temporarily
Other:
Estimated Start Date
*
MM
/
DD
/
YYYY
How did you hear about E-Nanny
*
Your answer
Children's Info (Name, Age, Gender)
*
Your answer
Are you expecting any more children within the year?
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Yes
No
Maybe
If any of your children have special, atypical or alternative needs, please describe.
Your answer
Please describe your home dynamic
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Busy
Peaceful
Chaotic
Loud
Structured
Unstructured
Organized
Other:
Required
Please describe your parenting model
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Authoritative
Attachment
Love and Logic
Whole Brained Child
Progressive
Passive
Positive
Babywise
Sears
Other:
Required
My children do not enjoy
Your answer
Daily Schedule/Routine
*
We have one
We'd like one
We don't need one
Eating Habits
*
Eats almost everything
Eats most foods
Eats some foods
Selective eater
Eating Restrictions
*
Vegetarian
Vegan
Kosher
Gluten-free
None
Clean
Other:
Are there any allergies (environmental or food)? If yes, please describe.
*
Your answer
Discipline
*
Not an issue
Might be an issue
Definitely an issue
Please describe your discipline style/philosophy
*
Your answer
Please list any household pets (specify indoor/outdoor, breeds, and approximate weight)
Your answer
Electronic Restrictions
*
Access to electronic media during the nanny's shift
Children have no access to tv, alternative screens (iPad, kindle, etc) or other electronic media
Children have limited access to tv, alternative screens, or electronic media
Children have unlimited access to tv, alternative screens, or other
Required
Please detail any other information we should know about your family (home dynamic, home culture, boundaries, expectations, goals, etc.)
Your answer
Nanny Work Schedule (please detail days and start and end times)
*
Your answer
Any additional scheduling information
Your answer
Will the nanny need to transport your child(ren)?
*
Yes
No
Maybe
Required
If yes, what will the nanny use to transport the children?
*
A vehicle is provided
The nanny will use their vehicle
The nanny will not transport my child(ren)
Hourly Rate
*
$15-18/hr
$18-20/hr
$20-25/hr
$25-30/hr
Other:
Required
What responsibilities will the nanny have?
*
Your answer
What qualities are you looking for in a nanny?
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Positive
Firm
Nurturing
Outgoing
Punctual
Gentle
Energetic
Interactive
Active
Creative
Athletic
Communicative
Educated
Structured
Mature
Playful
Reliable
Other:
Required
Years of experience preferred
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1-3
3-5
5-10
10 or more
Open to all experience levels
Other:
Required
Any additional nanny requirements? (education, particular skill, travel docs, health status, etc.)
Your answer
Are you comfortable with a nanny bringing her own child to work with her?
*
Yes
No
Maybe (for the right candidate)
What benefits and accommodations will you provide your nanny?
*
Employee Assistance Program (professional development, mental health support, etc)
Paid travel with family
Paid vacation
Paid sick time
Major holidays off
Annual bonus/Incentive bonus
Mileage Reimbursement (paid for travel at work for work purposes)
Vehicle Stipend (for the car and maintenance of vehicle)
Health Insurance Stipend
401k or Investment Stipend
Mental Health Stipend
Tuition reimbursement (for child related courses)
International Nanny Association Membership
Phone
Gym membership
TV (live-in)
Private bedroom (live-in)
Private bathroom (live-in)
Shared bath (live-in)
Other:
Required
Have you ever employed a nanny before?
*
Yes
No
If yes, please tell us what you liked and disliked about your previous nanny.
Your answer
For what reason is the nanny no longer employed with your family?
Your answer
What are the best days/times to contact you?
*
Your answer
I prefer to be contacted by
*
Email
Phone (call)
Phone (text)
Other:
Send me a copy of my responses.
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