Need a job? – Loving Care Nanny Services

Please complete all fields.

Are you looking for

Full- Time, Live-In

Full- Time, Live-Out

Part-Time

Latch-Key, After School

Summer

Birthdate

Address

Are you a U.S. citizen? If no, please provide evidence of status.

Yes

Are you currently employed? If yes, where? (company name, address, phone)

Yes

What high school did you attend?

What college did you attend?

What was your major field of study?

Briefly outline your experience in the following:

Childcare experience

Housekeeping experience

Will you do light housekeeping?

Yes

Will you cook for the children?

Yes

Please provide complete details of your work experience. Start with your latest position and go back from there. If there are any gaps in employment, please explain why.

Please list 3 or more references. At least one must relate to recent childcare work.
Name, Address, Phone No., Relationship to you:

Have you ever been convicted of a crime? If yes, please explain why.

Yes

Do you have a valid driver's license?

Yes

Driver's license # and state

Are you allergic to any animals? If yes, which animals?

Yes

Would you work in a home with pets?

Yes

Do you swim? If yes, how well?

Yes

Do you smoke? If yes, how much and can you agree to not smoke on the job?

Yes

Do you drink alcohol? If yes, how often?

Yes

Are you taking any medication that interferes with your mental/physical functions? If yes, please explain.

Yes

Is there any special area of town you want to work in?

Would you be willing to commit to a nanny position for at least one year?

Yes

How many hours a week would you like to work?

What age child do you feel most comfortable with?

How many children are you comfortable caring for at one time?

Briefly describe the worst childcare situation you have ever been in and how you handled it:

What are your strengths?

What are your weaknesses?

What are your hobbies?

Please add any additional information you would like to tell us about yourself:

ALL INFORMATION THAT I HAVE GIVEN IN THIS APPLICATION IS TRUE IN ALL RESPECTS. I UNDERSTAND THAT THE EMPLOYER WILL RELY ON THIS INFORMATION WHEN HIRING ME. IF ANY PART OF THIS APPLICATION IS FOUND TO BE FALSE CONCERNING MYSELF, I MAY BE IMMEDIATELY DISMISSED WITHOUT FURTHER OBLIGATION ON THE PART OF MY EMPLOYER AND/OR LOVING CARE NANNY SERVICES. I UNDERSTAND THAT LOVING CARE NANNY SERVICES IS NOT LIABLE OR RESPONSIBLE FOR ANY ACT INITIATED BY MYSELF, THE EMPLOYEE, OR THE EMPLOYER. I AGREE TO NOT HOLD LOVING CARE NANNY SERVICES RESPONSIBLE FOR ANY AND ALL CLAIMS, INCLUDING ATTORNEY FEES AND COURT COSTS, INCURRED BY ANY PERSON ARISING OUT OF MY EMPLOYMENT.

Signature of Applicant:

Date

Please type letters/symbols above.

Full Name Email Phone Number

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