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A Choice Nanny: Orlando
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Nanny Information Form

To apply for a job, please fill out the following form.

* Required Information
Contact Information
First Name: *
Last Name: *
Street: *
 
City: *
State: *
Zip Code: *
Home Phone: *
Cell Phone:
Work Phone:
E-Mail:
Best Time to Call:
Personal Information
Social Security Number: Format: nnn-nn-nnnn
General Location:
Areas You Will Travel To:
Consider Working in Another State?
Do You Drive?
Your Own Car?
Driver's License Number:
License State:
Ages of Children You've Cared For or Prefer:
Do You Smoke?
Prepare Meals?
Do Housework?
Like Pets?
Infant Experience?
Care for Handicapped?
Work Flexible Hours?
Take Your Child with You?
Can You Swim?
Care for the Eldery?
Job Information
Start Date:
Start End:
Salary Requested:
How long could you commit to a family:
Days and hours you can work:
Select "All" Jobs of Interest
Education
Select "All" Which Apply
Enter High School Information:
Name:
Location:
Dates Attended:
Year Graduated:
Enter College Information:
Name:
Location:
Dates Attended:
Degree Received:
Enter Other Education:
Other Training:
Field of Study:
Special Certificates:
Questionnaire
How did your hear about us?
List below anyone you know who might be interested in being a nanny:
Name:
Phone:
Name:
Phone:
Why are you interested in a child care job?
 
Check "all" the job situations you would feel comfortable with:
 
What do children like best about you?
 
What would you do to keep a toddler busy on a rainy day?
 
What forms of discipline do you use?
 
How would you handle a 2-year-old's temper tantrum?
 
How would you handle a 4-year-old who spilled milk?
 
How does child care fit into your future?
 
What was your childhood like?
 
Number of siblings:
Did your mom work?
Check "all" the tasks you are willing to do:
 
Are you signed up with any other nanny services?
Which ones (include other A Choice Nanny offices)?
 
Enter Emergency Contact Information:
Name:
Relationship to you:
Phone:
Nearest relative not living with you:
Phone:
Do you use alcohol, nicotine, drugs? If yes, please explain.
 
List all allergies that might affect your job?
 
Do you have any physical conditions that might affect your performance as a nanny?
 
   
 
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