Parent Registration

First Name:

Last Name:

Occupation(s):

Street Address:

City:

State:

Zip Code:

Subdivision or Nearest Intersection:

Day Phone:

Evening Phone:

Email Address:

Fax Number:

Job Start Date:

Number of Children: Girl(s)   Boy(s)

Ages of Children:

Special Needs or Requirements for Children:

Type of Caregiver Required: Please Choose... Part Time: 20-29 Hrs Full Time: 30-44 Hrs Live-In Nanny Temporary Summer Only Elderly Companion

Describe age, personality/skills preference of Nanny:

Does your Nanny need to be a non-smoker? Please Choose... Yes No Does not matter

Does anyone in your household smoke in the home? Please Choose... Yes No

Drivers License Required? Y/N:

Own Vehicle Required? Y/N:

Will you provide a vehicle for the Nanny? Y/N:

Schedule required:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Weekly Hours Required: Please Choose... 20-29 Hours 30-44 Hours

Describe the hours needed ie:  9:00am-5:00pm:

 

Will there be occasional overtime? Y/N:

Wages Prepared to Offer: Please Choose... Minimum Wage $9-10 per hour $11-12 per hour $13-14 per hour Undecided

Will you be paying vacation pay, stat pay, overtime? Y/N:

Brief job description/duties required:

Prepare Children's meals

Prepare Family Dinner

Pack School lunches/snacks

Vacuum

Dust

Mop

Children's Laundry

Change Linens

Make Beds

Clean Children's rooms

Tidy Playroom

Other

Activities Preferred:

Reading

Alphabet/Counting

Crafts

Outdoor Activities

Languages

Field Trips

Social Outings

Playdates with other FCC Nannies

Time commitment required - short-term (less than 6 months), Long-term 1 year+:

Pets in the home, if yes please specify:

Pool? Y/N:

Do you require a Nanny who can swim? Y/N:

Will your Nanny accompany your family on vacations? Y/N:

For Live-in only, please describe the Nanny living arrangements available:

Have read and agree to Parent Terms and Conditions