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Contact Information
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Parent #1
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Parent #2
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Address (City, State, Zip)
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Parents Home Numer & Email Addresses
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Parent #1 Occupation
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Parent #1 Office Number
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Parent #1 Cell Phone Number
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Parent #2 Occupation
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Parent # 2 Office Number
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Parent #2 Cell Phone Number
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How did you hear about The Happy Nanny LLC
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Please provide name of the source
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Children Information
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Please list the names, ages, gender, grades (if applicable), and special interest of each child in the home.
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If any of your children have special needs, please explain:
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Are you expecting any other children in the next year?
Yes
No
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Please Explain:
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Nanny Information
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What responsibilites will the nanny have?
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What qualities are you looking for in a nanny?
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Will a car be required to transport children?
Yes
No
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Please check all that you require from a nanny:
Swimmer
Does light housework for the children
Does light house work for the family
Does heavy house work
Cooks for children
Cooks for the family
Assist with homework
Run errands
Takes children to extra curricula activites
Grocery shops
Care for the pets in the home
Stays overnight
Travels with the family
Ability to assist mom with new baby
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Additional Qualities:
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What accomadations and benefits will you provide your nanny (live-in & Full-time nannies)?
Private Room
Private Bathroom
Shared Bathroom
TV
Phone
Health Insurance
Paid Travel with the family
Paid Vacation
Major Holidays off
Bonus
Tuition reimbursement for child related courses
vehicle
other
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Please explain:
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Will you allow your nanny to bring their own child to work?
Yes
No
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If yes, please explain:
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Have you ever employed a nanny before? If yes, please explain likes, dislilkes, and reason nanny is no longer employed by the family?
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If you have any dietary restrictions in your household, please explain?
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Do you have any household pets (list weight of dogs), if so please explain:
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We are looking for:
Live-In
Live-Out
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The position is for:
Full-time (40 + hours)
Part-time (less than 35hours)
Mommy/Daddy Helper
After-School Care
Weekend Care
Temporary/Short Term assignment
Occasional (wedding, party, reunion, etc.)
Winter/Spring/Summer/Fall Break
Holiday Care
Back-up Care
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Explain:
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Nanny Work Schedule
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Desired Start Date
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Monday
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Tuesday
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Wednesday
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Thursday
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Friday
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Saturday
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Sunday
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Please provide any other pertinent information that will help us provide your family with the BEST care possiable:
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Pay Rate
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Weekly/Bi-weekly Gross Income (if uncertain, provide range):
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Hourly Rate
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Overtime Pay
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Overnight Pay
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Family Information Session (Required)
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When is the best day for a family information session with The Happy Nanny staff?
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When is the best time for a family information session with The Happy Nanny Staff?
Hours
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Minutes
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Please add one additional date and time for your family session (we will make every effort to meet the needs of your family).
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