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Nanny Application for Employment
Name: Date:
Home address: City Zip Code
Phone: home work cell
Preferred areas for employment:
Are you eligible to work in the U.S.? How were you referred to Babies to Boomers?
Days/ Hours Available: Do you have an insured, reliable vehicle?
In case of emergency, please contact: Phone: Relationship to you:
EDUCATION:
High School:
College:
College:
Trade School:
Other Courses:
Have you had CPR? Expiration date: 1st aid? Expiration date:
Have you taken Child Development courses?
Have you taken any Education classes? Home Economics classes?
E-mail address:
Degree
Dates Institution City State Last Grade Completed Area of Study
Type of position you are seeking (check as many as apply):
Permanent Full-time Days Weekends 24 Hour/Overnight
Temporary Part-time Evenings Live-in Work around school schedule
PERMANENT CHILD CARE EXPERIENCE: Please list jobs of 3 months or more, i.e. nanny, day care, teaching, etc.
Dates Employer & Supervisor Address Home/Office Phone # of Children/Ages
1.
Reason for leaving: Gross Salary:
2.
Reason for leaving: Gross Salary:
3.
Reason for leaving: Gross Salary:
4.
Reason for leaving: Gross Salary:
Attention: Prior to filling out a form, please contact Babies to Boomers at 802-540-0433 to request special instructions
on the form submission process. We want to ensure that your form reaches us, and are happy to help with the process!
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