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Nanny Application

Full Name

Gender

Female

Male

Nanny's Age

Date of birth

Address

City

State

Postal code

Phone *

Email *

Nanny's Experience

Please fill out to the best of your ability.

How many hours a week are you available? What time of day are you available?

Are you able to travel? If so, do you have a passport?

What is your desired rate?

Can you cook and prepare meals?

Please describe what you believe are your best qualities when it comes to being a nanny

Please check all that apply

CPR Certified

First Aid Certified

Swim Certified

Certified Childcare Director

Flu Vaccinated

COVID-19

Are you legally authorized to work in the United States?

Yes

No

Is there a certain age you prefer or have more experience with?

What is your primary language? Do you speak any other languages? If so, explain your proficiency in each.

What is the estimated length of time you are wanting to stay in a position? (months/years)

How did you hear about HoustoNanny?

Is there anything else you would like us to know about you?

Additional Information

Are you willing to do light housework?

Yes

No

Would you be open to working overtime?

Yes

No

Is your schedule flexible?

Yes

No

Do you have a reliable car?

Yes

No

Are you available on the weekends if needed?

Yes

No

Do you require you are paid for holidays, vacations, and sick days?

Yes

No

Can you cook and prepare meals?

Yes

No

Are you ok with pets in the house?

Yes

No

Are you looking for a Live-In or Live-out position?

Live-In

Live-Out

Do you smoke?

Yes

No

Education: High School

Education: College

Nanny References

Please add up to 4 child care references that we may contact Please include: First and last name, full address, phone number, length you worked for this person, number of children and ages cared for

Work history

Please include: Company name, employer address, employer phone number, list of duties Please add all work history from the past 2 years

Please check the box below if you agree.

I hereby attest that all of the above information is true and accurate. I further agree that I will not accept employment from any of HoustoNanny clients or referral of HoustoNanny client without the express permission of HoustoNanny. By selecting "I agree", I fully agree and accept the statement above.

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