NannyQuest Candidate Application Form

NannyQuest Candidate Information Form

NannyQuest Clients will view this application. Please fill out each section completely and check spelling.
Click on the title to view section.

general information


First, MI, Last:		Position applied for:
Address:		DEsired Salary:
Street, Apt. unit #:		Date Available:
City, State, Zip:		Email Address:
Home phone:		Emergency Contacts:
Work phone:
Cell phone:
Are you Legally authorized to work in the U.S.?		Do you have your own dependable transportation?
Have you ever been convicted of a crime?		Are you willing to transport children in your car with gasoline reimbursement from employer?
If yes, explain:		List any offenses that appear on your driving record for the last SEVEN years. This will include all moving and non moving violations. Example: speeding tickets, accidents, stop signs/red lights, etc. Please contact NannyQuest with questions or obtain a copy of your seven year driving record from your local police department.

Education

High School
Name:		Address:
From:		Did you graduate?
To:		Degree:

College
Name:		Address:
From:		Did you graduate?
To:		Degree:
Major:		Minor:

Other
Name:		Address:
From:		Did you graduate?
To:		Degree:
Major:		Minor:

previous employment

Please do not leave gaps in employment history

Most Recent
Company:		Phone:
Address:		Supervisor:
Job Title:		Email:
Responsibilities:		Reason for leaving:
From:		Reason for leaving:
To:		May we contact your previous supervisor for a reference?

Next Recent
Company:		Phone:
Address:		Supervisor:
Job Title:		Email:
Responsibilities:		Reason for leaving:
From:		Reason for leaving:
To:		May we contact your previous supervisor for a reference?

Next Recent
Company:		Phone:
Address:		Supervisor:
Job Title:		Email:
Responsibilities:		Reason for leaving:
From:		Reason for leaving:
To:		May we contact your previous supervisor for a reference?

Employment Timeline

Please provide a brief description of your employment history for the past 10 years


2003:		2008:
2004:		2009:
2005:		2010:
2006:		2011:
2007:		2012:

childcare / Household staffing references

Please list four references. Do not list family or friends.

Reference 1
Name:		Relationship:
Company:		Phone:
Number of children cared for:		Email:
Ages of children:		From:
Was this a nanny position or on-call, as needed childcare?		To:
Reason for leaving:		If a nanny position, approximate hours worked weekly:

Reference 2
Name:		Relationship:
Company:		Phone:
Number of children cared for:		Email:
Ages of children:		From:
Was this a nanny position or on-call, as needed childcare?		To:
Reason for leaving:		If a nanny position, approximate hours worked weekly:

Reference 3
Name:		Relationship:
Company:		Phone:
Number of children cared for:		Email:
Ages of children:		From:
Was this a nanny position or on-call, as needed childcare?		To:
Reason for leaving:		If a nanny position, approximate hours worked weekly:

Reference 4
Name:		Relationship:
Company:		Phone:
Number of children cared for:		Email:
Ages of children:		From:
Was this a nanny position or on-call, as needed childcare?		To:
Reason for leaving:		If a nanny position, approximate hours worked weekly:

tell us about yourself


When can you begin working?		Do you have experience with newborns?
CAn you make a minimum of a one year commitment?		Do you have experience with twins?
Are you currently in school? If so, what hours:		Do you like to cook?
Do you have schedule limitations? please be specific		List any certifications including infant & toddler CPR, adult CPR and others:
Live in, or live out:		Are you willing to travel?
Tell us about your unique Interests, talents and hobbies:		Do you have a valid passport?
Do you need health insurance?		Do you have any experience with special needs children? If so, explain
Do you like animals?		How well do you swim?
Will you assist with pets?		Are you comfortable swimming with children?
What languages do you speak, other than english?		What was the last book you read?
Will you run errands?		Are you willing to relocate?
What are your long term goals in life?		Will you do child related housekeeping? (nanny applicants)
Describe your past nanny/childcare experience. Include volunteer work, etc...		Other skills:

Housekeeping / Home Management


	Do you have experience with the care of valuable china, crystal, marble floors, etc. ?
	Will you sweep outside and clean off patio furniture?
	Do you iron?

your health


	Do you smoke?
	Do you have any allergies, including those to pets?
	Do you have any health conditions that would prohibit you from doing the job correctly?

personal profile


Tell us about yourself:		Describe your philosophy of childhood discipline:
Why Do you wish to be a nanny/professional caregiver or household manager at this time in your life?		What do you, more than anyone else, have to offer a nannyquest family?
What is your greatest strength?		Where do you see yourself in five years?
What is your greatest weakness?		Describe the most difficult time you have had with a child and tell us how you dealt with it:

By submitting this form I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.