Pre-Employment Questionnaire

Are you a U.S. citizen?

If NOT, are you eligible to work in US?

Position Desired:
Please check all that apply.

If looking for a permanent job, can you commit to a year?

All of our placed nannies must have current CPR certification. We will give you ample time to get certified.

Are you CPR certified?

(optional)

Do you have allergies?

Do you smoke?

Do you swim?

Do you have a valid driver’s license?

Do you have a car?

Are you:

Do you have any children?

Education

Did you Graduate?

Did you Graduate?

Currently Attending?

Are you fluent in any other languages?

Work Experience

May we call your current employer?

EMPLOYMENT: List most recent jobs first.

Give name and phone numbers of PERSONAL references not related to you.

Do you have any experience working with a special needs child?

Cared for a nursing baby?

Toilet trained?

Taught a child to swim?

Ages of children that you have worked with in the past

Do you like to cook?

Thank you! Your submission has been received!
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