Contact Information
Contact Person Name:
Place of Employment:
Work Phone:
Mobile Phone:
E-Mail Address:

Spouses Name:

Place of Employment:
Work Phone:
Mobile Phone:
E-Mail Address:
Home Address:
Zip Code
Home Phone:
Best Time to Call:
Best Person to Call:
Please Describe your children:
Birth date
School Hours
Male Female
Male Female
Male Female
Male Female

Have you ever employed a nanny?

Yes No

If so, please describe the relationship:

Please list any pets:






Please note anything else about your family/household you feel is important for us to know:






Nanny Information:
Live Out Live In  
Full Time Part Time Summer
Start Date:
Nanny Pay
Weekly Gross (Before Taxes):
Weekly Net:
Benefits(vacation, holidays, health insurance):







  Please check all the duties you would like your nanny to be responsible for related to the child(ren).
Children's Laundry
Bathing Children
Preparing Meals for Children
Daily Log of Children's Day
Picking up after Children
Reading to Children
Age Appropriate Activities

Do you want your nanny to transport your children:

Yes No

If yes, please describe:

Would you provide a car?

Yes No

Would you reimburse your nanny for mileage?

Yes No

If so, at what rate?

Are you a non-smoking family?

Yes No

Please describe the personality of a nanny that would best suit your family (athletic, outgoing, laid back).
Please describe a typical day.
Please describe special requirements you are looking for (i.e. religion, education, experience).
Please describe your discipline style.
If live-in, please describe living accommodations.
** How did you hear about Metropolitan Nannies? (required)
Permanent Services Client Understanding and Release:

Understanding between parties:
Please Read!

1. Metropolitan Nannies, LLC. (“Metropolitan Nannies”) agrees to make its best effort to locate temporary child caregivers (“Caregivers”) upon request by the below-signed client (“Client”).

2. Rate: Client agrees to pay Caregivers directly for services rendered at least $15.00 per hour for 1-2 children and $1.00 per each additional child per hour, with a four-hour minimum.

3. Client understands that a non-refundable agency reservation fee will be charged to Client’s credit card upon Metropolitan Nannies’ confirming Client’s reservation for a Caregiver.

4. Client agrees to notify Metropolitan Nannies of any job cancellation and authorizes Metropolitan Nannies to automatically bill client's credit card a cancellation fee of $25 if client cancels a job after confirmation by a Metropolitan Nannies employee. If client cancels a confirmed reservation within 24 hours of the scheduled visit, Client will be charged for four hours of the Caregiver’s time in addition to the agency reservation fee. Client acknowledges that jobs placed with less than 24 hours advanced notice will incur a $25 surcharge to be automatically billed to client's credit card in addition to any other applicable fees.

5. Client understands that the services provided by all Metropolitan Nannies' Caregivers must be contracted through the Metropolitan Nannies office. Client further understands that the use of a Metropolitan Nannies' Caregiver or the referral of a Metropolitan Nannies' Caregiver to a third party, without arranging the visit through Metropolitan Nannies, is considered “theft of services” and will result in a charge of $1,000 in liquidated damages.

6. In the event that Client wishes to hire a Caregiver on a permanent basis, Metropolitan Nannies agrees to negotiate with Client in arriving at an acceptable placement fee. Metropolitan Nannies' standard placement fee for a Permanent Caregiver ("Nanny") is the greater of 15% of the caregivers annual gross salary or $4,000 for a full-time placement (30 or more hours per week) is the greater of 15% of the caregivers annual gross salary or $2,500 for a part-time placement (less than 30 hours per week).

7. Client understands that Metropolitan Nannies' Caregivers are not employees of Metropolitan Nannies. Client understands that Client may be responsible for withholding and filing employment taxes for each calendar year in which the Caregiver’s payments exceed the limits set forth in the Internal Revenue Code. Social Security numbers of caregivers must be obtained directly from Caregivers.

8. Client agrees to indemnify, release and hold harmless Metropolitan Nannies, its agents, employees and officers for any and all claims relating to or arising out of the services provided inby Caregivers.


by initialing here, I have read and understand the terms of the agreement. (Outlined again, below)




Please Enter The Main Contact Persons Name.
Please Enter Your Spouses Name.