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Raleigh Office Nancy's Nannies, Inc.
 
 
 
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Nanny Application
Thank you for applying with Nancy's Nannies, Inc. We place full and part time nannies in eastern North Carolina. You must have child care experience, transportation and be CPR certified to qualify for a nanny position. If you have a resume, please send with the application. See the Nanny Agreement on the last page for more information. You may contact either office if you have questions. We will be in touch with you upon receipt of your application.
E-Mail Address
Name
Permanent Address
City
State
Zip
How long at this address? 
Current Address (if different)
City
State
Zip
Home Phone
Best time to call
Business Phone
Best time to call
Ages of Children
JOB REQUIREMENTS
Position:
Live In
Live Out
Date Available
Desired Compentsation
Preferred Age Group
From
To
Number of Children Preferred: 
Are you willing to do: (check all applying)
  Light housekeeping
  Full housekeeping
  Cooking (family)
  Laundry (family)
  Errands
  Travel with family
  Work overtime
Type family preferred: (check all applying)
  Working Mom
  Non-Working Mom
  Dual Parent Family
  Single-parent Mom
  Single-parent Dad
  All of the above
Would you stay longer than one year? Yes No
How much longer?
NC Location preferred: (check all applying)
  New Bern
  Jacksonville
  Morehead City
Raleigh
Wilmington
Other, Please Specify:
Have you worked with special needs children? Yes No
If yes, explain:
Would you enjoy working with children with special needs? Yes No
Would you work where there are pets? Yes No
If no, reason:
Do you drive? Yes No
Standard? Yes No
Do you have access to a car? Yes No
Type car: Year
Do you have car insurance? Yes No
Insurance Company
EDUCATION
HIGH SCHOOL OR GED
Name and Location of School
Years Completed
Did you graduate?
Subjects Studied
GED, Degree or Diploma Rec'd
If not graduated, reason
COLLEGE
Name and Location of School
Years Completed
Did you graduate?
Subjects Studied
Degree Rec'd
If not graduated, reason
GRADUATE SCHOOL
Name and Location of School
Years Completed
Did you graduate?
Subjects Studied
Degree Rec'd
If not graduated, reason
TRADE, BUSINESS OR CORRESPONDENCE SCHOOLS
Name and Location of School
Years Completed
Did you graduate?
Subjects Studied
Degree or Diploma Rec'd
If not graduated, reason
GENERAL
Do you speak any foreign languages? 
Do you play any musical instruments?
Memberships in clubs, organizations
Special licenses, awards
CPR Certified? Yes No Date
First Aid Certified? Yes No Date
Can you swim? Yes No Explain ability
CHILDCARE EXPERIENCE
1.
Name
Telephone (Home)
Address
Telephone (Business)
City
State
Zip
Occupation
Position Held
Dates
From To
Lived in/out?
FT/PT
Children's Ages
Reason for Leaving
2.
Name
Telephone (Home)
Address
Telephone (Business)
City
State
Zip
Occupation
Position Held
Dates
From To
Lived in/out?
FT/PT/Occas
Children's Ages
Reason for Leaving
3.
Name
Telephone (Home)
Address
Telephone (Business)
City
State
Zip
Occupation
Position Held
Dates
From To
Lived in/out?
FT/PT/Occas
Children's Ages
Reason for Leaving
PROFESSIONAL OR VOLUNTEER EXPERIENCE
LAST OR CURRENT EMPLOYER / VOLUNTEER POSITION
From   to 
Name and Address of Employer/Volunteer Position
Tel. #
Supervisor
Salary (if any)
Position
Reason for Leaving
PREVIOUS EMPLOYER / VOLUNTEER POSTION
From   to 
Name and Address of Employer/Volunteer Position
Tel. #
Supervisor
Salary (if any)
Position
Reason for Leaving
PREVIOUS EMPLOYER / VOLUNTEER POSITION
From   to 
Name and Address of Employer/Volunteer Position
Tel. #
Supervisor
Salary (if any)
Position
Reason for Leaving
PREVIOUS EMPLOYER / VOLUNTEER POSITIONS
From   to 
Name and Address of Employer/Volunteer Position
Tel. #
Supervisor
Salary (if any)
Position
Reason for Leaving
MEDICAL INFORMATION
Do you smoke? Yes No How much?
ADDITIONAL INFORMATION
Have you ever been convicted of a felony?

Note: Please do not include any information about any arrest or detention that did not result in a conviction; any conviction where your record has been expunged, sealed or eradicated; any misdemeanor conviction where you have completed probation and the case has been dismissed; or any arrest where you have successfully completed a pretrial diversion program.

*The existance of a criminal record is not an absolute bar to referrals or employment.*		 Yes No
If yes, explain with dates
Why are you interested in this position?
What are you future goals and plans?
In an emergency, who should be notified?
Name
Address
Telephone (Home) Telephone (Business)
ADDITIONAL INFORMATION
QUESTIONS
The following questions are an important part of this application.  Please enter your answers in the box provided below each question.
  1. Why do you want to be a nanny?
  2. Why do you feel you would be a good nanny?
  3. Describe your experiences with children (include scope of responsibilities, training, etc.)
  4. What have your experiences taught you about young children?
  5. How would you discipline a misbehaving child?
  6. Describe a difficult situation that you've had with a child and how you handled it.
  7. How would you describe your life growing up?
  8. How do you enjoy your leisure time?
  9. How would you describe yourself?
  10. What are your strengths?
  11. What are your weaknesses?
  12. What values are most important in your life?
  13. Do you have any friends or relatives in North Carolina?
  14. What would you do if you and host family disagreed on something?
  15. What do you see as the nanny's role in the family?
  16. Is there anything else that you would like to say or feel that we should know that would affect your life as a nanny? Tell us about yourself, your goals, and what your expectations of a nanny job are. 
NANNY AGREEMENT
NANCY'S NANNIES, INC. IS A NANNY PLACEMENT AGENCY.  WE WILL MAKE REASONABLE EFFORTS ACCORDING TO APPLICABLE LAW TO MATCH YOU WITH AS MANY FAMILIES AS POSSIBLE BASED ON THE INFORMATION YOU HAVE PROVIDED.  OUR FEE IS PAID BY THE FAMILY HIRING YOU.  IF YOU ACCEPT EMPLOYMENT WITH A FAMILY WE HAVE REFERRED YOU TO, OR ONE YOU FIND ON YOUR OWN, YOU MUST NOTIFY US IMMEDIATELY.

WHEN A FAMILY HIRES YOU, YOU BECOME THE FAMILY'S EMPLOYEE.  NANCY'S NANIES IS NOT YOUR EMPLOYER. THE FAMILY IS RESPONSIBLE FOR PAYING YOUR SALARY DIRECTLY TO YOU. YOU AND THE FAMILY ARE RESPONSIBLE FOR HOUSEHOLD EMPLOYMENT TAXES.  ADDITIONAL BENEFITS OFFERED VARY WITH EACH FAMILY.

WE OFFER A 30-DAY TRIAL PERIOD.  WE WILL BE HAPPY TO HELP YOU NEGOTIATE ANY PROBLEMS DURING THAT TIME IF NEEDED.  PLEASE KEEP IN MIND THAT COMMUNICATION BETWEEN YOU AND THE FAMILY WILL BE MOST IMPORTANT AND IT IS YOUR RESPONSIBILITY TO KEEP US INFORMED.

WE WILL DO REFERENCE CHECKS AND BACKGROUND CHECKS.  THIS MAY INCLUDE, BUT IS NOT LIMITED TO, CRIMINAL CHECKS, DRIVING RECORD, AND ANY OTHER INFORMATION THAT MAY BE NECESSARY.

I certify that all information I provided in this application is true, accurate, complete and correct. I authorize investigation of all information provided in this application unless I have indicated otherwise. I authorize the references I listed to provide all information concerning my prior employment and any other information they may have regarding me and my character. I authorize the disclosure of any information about me, including but not limited to information I and my references have provided, to potential employers. I understand and agree that any misrepresentation, falsification or material omission of information on this application may be grounds for Nancy’s Nannies to refuse to refer or place me with its clients.

I understand that Nancy’s Nannies does not unlawfully discriminate in referrals or placements, and no question on this application is used for the purpose of limiting or excusing any applicant for consideration for referral, placement or employment on any basis prohibited by applicable laws or regulations.

I release Nancy’s Nannies and its owners, agents, employees, officers, directors, attorneys, representatives and affiliated entities and any other persons or entities from any and all liability as a result of soliciting, providing or receiving information regarding me or my character, or the use or disclosure of such information.

DO NOT SUBMIT YOUR APPLICATION UNTIL YOU HAVE READ AND AGREED TO THE ABOVE NANNY AGREEMENT. CLICKING BELOW CONSTITUTES YOUR AGREEMENT TO ALL TERMS LISTED HEREIN.

TYPE YOUR FULL NAME: 
DATE:  Wednesday, May 14, 2008

THANK YOU FOR REGISTERING WITH NANCY'S NANNIES, INC.

Which office would you like to send this application to?
Morehead City
Raleigh

 
© 2006 Nancy's Nannies, Inc.
All rights reserved.
For more information call 1-252-726-6575.