NannyQuest.net Client Form

NannyQuest Client Information Form
 

 

Submission of this form will begin your process.  A $250 application fee is due before we can begin working.  A NannyQuest Introduction Packet and Contract will be sent to you via email.


 

Personal Information

First name:

Last name:

Address:

Street:

City:

State:

  

Zip:

E-mail:

Home phone:

Fax #:

Work phone:

Cell #:

       

 

Household Information

  Name, Age, Birthdate:  

Children (names, ages, birthdates):

 

Father's Occupation:

Company name:

Mother's Occupation:

Company name: 

Proposed Weekly Salary for Nanny or Other Domestic
Help.  (Net):

 $.00  

Referred by:

  

Do you employ a housekeeper?

 yes no  

Describe the employee you are looking for:

 

Hours:

a.m. til p.m.

 

Duties:

 

Live

Do you have pets?

  

Describe your pet(s) if applicable:

  
     
 

General Information

   

Start date:

Can you provide health insurance (or contribute towards?):

Yes No

Is a car provided?:

Yes No

Describe the living quarters for employee (if applicable):

Additional comments:

Give us some windows of time when you can conveniently interview:

Please give detailed directions to your home from one of the major highways:

 

  

 

 

 

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