NANNY APPLICATION  
First Name:
Last Name:
Street Address:
City:
State:
Zip Code:
E-Mail Address:
Wok Phone:
Home Phone:
Mobile Phone:
Best Time to Call:
Driver's License? Yes No
Age:
Gender: Male Female
Start Date:

Geographic Areas Preferred
1
2
3
4

Desired Salary
Weekly Gross (Before Taxes):  
Availability    
Live Out Live in  
Full Time Part Time Summer/Short Term

Hours Available
Temporary:    
Weekdays Weeknights Weekends
Over Night    

Please fill in all the duties you are willing to do related to care of child(ren):
Laundry
Feeding
Bathing
Preparing Meals
Cleaning
Reading to Children
Age Appropriate Activities
Other:

Please fill in all the duties you are willing to do that are non-child related:
Housekeeping
Laundry
Errands
Cooking
Other:

 
Are you trained in Infant/Child CPR? Yes No
Do you have experience with Infant Care?
Do you know First Aid? Yes No
Can you swim? Yes No
Are you willing to travel? Yes No
   
Are you willing to drive the children around? Yes No
If so, do you have an insured car? Yes No
Make/Model:
Please describe your driving record:
   
Have you ever been arrested? Yes No
If yes, please describe:
Have you ever been convicted of a crime? Yes No
If yes, please describe:
   
Would you work in a home with pets? Yes No
Do you smoke? Yes No
How would you rate your overall health?

Employment History (Non-Childcare Related)

Employer1
Name:  
Phone Number:  
Address:  
From: To:
Gross Salary (before taxes):  
Please describe duties:
Reason for Leaving:
Can We Contact? Yes No  
Employer 2    
Name:  
Phone Number:  
Address:  
From: To:
Gross Salary (before taxes):  
Please describe duties:
Reason for Leaving:
Can We Contact? Yes No  
Employer 3    
Name:  
Phone Number:  
Address:  
From: To:
Gross Salary (before taxes):  
Please describe duties:
Reason for Leaving:
Can We Contact? Yes No

Childcare References (These can be the same as your employment history references listed above. if they are childcare related)

Reference 1
Name:  
Address:  
Phone Number:  

Children (Age & Sex):

  
Start Date  
End Date  
     
Reference 2    
Name:  
Address:  
Phone Number:  

Children (Age & Sex):

  
Start Date  
End Date  
     
Reference 3    
Name:  
Address:  
Phone Number:  
 

Children (Age & Sex):

  
Start Date  
End Date  

Questions
Why do you want to be a nanny?
What types of activities do you enjoy doing with children?
Please describe a typical day with a child you have been a care provider for.
Describe your personality.
What are your hobbies and interests?
What are your future goals?
Describe your discipline philosophy.
I am happiest when:
A bad day is when:
** How did you hear about Metropolitan Nannies? (required)