Sitter / Nanny Profile

Personal Information

Age:

Name:

Street:

City:

State:

Zip:

email:

Phone:

Cell:

Other:

Preferred method of contact:

Cell Phone Home Phone email Other Phone

Position/Schedule

Desired Position:

Minimum Desired Salary (Nanny Position): per hour

Fill in the days and times you are available to work:

Monday from

Tuesday from

Wednesday from

Thursday from

Friday from

Saturday from

Sunday from

When can you start?

Desired hours per week?

Schedule good through?

Expected new schedule?

Available to work:

Exceptions?

Certifications

CPR - Expiration:

First Aid - Expiration:

Trustline - Date:

Other - Expiration:

Are you willing to become certified/ renew certification within 2 weeks of start date?

Yes No

Relocation Plans

within the next six months?

within the next year?

Expected date of relocation?

Where?

Reason?

General

OK with animals (dogs, cats, etc)?

Do you cook?

Vegetarian/vegan and/or organic meals?

Are you willing to do light housekeeping?

Do you smoke?

Do you have any allergies (animals, plants, foods)?

If yes, please list:

Are you currently taking any medications that would impair your judgement/ability to drive?

Do you have any physical or mental limitations that could affect your ability to do your job?

Have you ever been convicted of a crime?

When?

Where (city/state)?

Driver's License # and expiration:

Vehicle Year/Make/Model:

Number of accidents in past 3 years?

Number of moving violations in past 3 years?

Ages of children you prefer to work with - Check all that apply

Please answer the following questions as best you can. Be specific.

1. How would you soothe a crying infant?

2. You’ve noticed that the 8 month old in your charge is drooling a lot, running a low grade fever, and is fussy. What could be the problem? How would you soothe him/her?

3. You are taking a 3 yr. old on an outing to the park. What should you pack to take with you?

4. It’s lunchtime for the 2 yr. old in your care. What are some things you would offer him/her to eat?

5. Tell us about yourself as a Sitter/Nanny - what activities you enjoy doing with children? What do kids (and their parents) like about you?

References

Please provide 4 references - at least 2 must be childcare specific. (unrelated references preferred - volunteer / unpaid experience OK)

Name:

Relationship:

From: To:

Phone:

email:

Best time to call:

Notes:

Name:

Relationship:

From: To:

Phone:

email:

Best time to call:

Notes:

Name:

Relationship:

From: To:

Phone:

email:

Best time to call:

Notes:

Name:

Relationship:

From: To:

Phone:

email:

Best time to call:

Notes:

Experience Profile

Work Experience: (Most recent position first)

Employer:

Address:

Phone:

Supervisor:

Job Title:

From: To:

Wage $: per:

Reason for leaving (be specific):

Duties and responsibilities:

Skills:

Employer:

Address:

Phone:

Supervisor:

Job Title:

From: To:

Wage $: per:

Reason for leaving (be specific):

Duties and responsibilities:

Skills:

Employer:

Address:

Phone:

Supervisor:

Job Title:

From: To:

Wage $: per:

Reason for leaving (be specific):

Duties and responsibilities:

Skills:

Education

High School:

City, State:

From: To:

GPA:

Diploma?

College:

City, State:

From: To:

Major:

Degree?

May we contact your present employer?

Are you willing to submit to a full background check?

Are you willing to be tested for illegal drugs?

Is all of the above information true?

Signature of Applicant:

Date: