Name(s) of employer: ____________________________________
____________________________________
Address: ____________________________________
____________________________________
Name of nanny: ____________________________________
Address: ____________________________________
____________________________________
Social Security # ____________________________________
Number of children: ____________________________________
Names of children: ____________________________________
____________________________________
____________________________________
____________________________________
Start date: _________________
Schedule
Hours needed on a set, weekly basis and times off:
Monday _________________________
Tuesday _________________________
Wednesday _________________________
Thursday _________________________
Friday _________________________
Saturday _________________________
Sunday _________________________
Number of sick days: ______
Number of personal days: ______
Nanny will give employer ______ days notice for personal days and
will call by ______a.m. on the rst day of illness.
Duties
List the responsibilities you need the nanny to fulll. Being specic in
this area increases the likelihood there will be less misunderstandings
and a better satisfaction for both parties. (Ex. Dispensing of
medication, ongoing playdates, laundry on specic days.)
sample nanny contact
13117 Eastpoint Park Blvd.
Ste. H
Louisville, KY
(502) 895-9998
(502) 638-2502 fax
After Hours: (502) 541.6441
Owners Kevin and Laura Hall
info@FamilyTreeCareServices.com