Nannies, Babysitters, Baby Nurses, Housekeepers, Caregivers, Companions, Teacher Assistants,
Full Time & Part Time, Long Term & Short Term, Temporary, Live-in Nannies, Live-out Nannies

Nanny Application

Nanny responsibilities are suited to meet your unique needsThank you for your interest in working with All Best Nannies. We are a Nanny and Child Care Referral Agency. We hope being a Nanny will be a wonderful experience for you. Candidates are referred to potential family employers based on job requirements that match candidate’s experience, geography, salary requirements, and personal preferences. Our placement consultants will work with you to help make the hiring process as smooth as possible.
All candidates must be available for an in person interview in our office: 2644 Dempster St Suite 109 Park Ridge Il 60068

Candidate requirements:

 

Date: 5/9/2008 7:59:17 AM
Last name: Age:

First name & Initial:

Mr. Ms. Mrs.
Phone: Other:
Address: How long at this address:
City: ZIP:
Date available to work: Are you willing to live-in? Yes No
Do you have children? Yes No Ages of your children:
Do you drive a car? Yes No
Do you have a car available? Yes No
Do you have a driver's license? Yes No
 
English language:
Can understand, but do not speak well
Can carry on a limited conversation
Can speak and understand very well
 
Country of Origin?
 
Type of work desired: Housekeeper
Baby-sitter/nanny

Companion for elderly or disabled
Other

Other work I am willing to do (and know how to do):
Light house cleaning Child Care Ironing Driving
Light cooking Family cooking Laundry Shopping
 
How much money do you require? $ per hour $ per week
 
Are you available for full-time work? Yes No
Are you available for part-time work? Yes No
 
Please list the days and hours you are available to work:
Day Hours (from) Hours (to)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
 
FORMER EMPLOYERS (list below your last three employers, starting with the last employer first)
1.
Employed (from) date: Employed (to) date:
Name of employer
Address: City, State, Zip:
Position:
If CNA or Companion, how old was your patient? years Patient was Male Female
If baby-sitter, how many children? Ages of children when started
Reason for leaving:
Contact person: Home phone: Other phone:
 
2.
Employed (from) date: Employed (to) date:
Name of employer
Address: City, State, Zip:
Position:
If CNA or Companion, how old was your patient? years Patient was Male Female
If baby-sitter, how many children? Ages of children when started
Reason for leaving:
Contact person: Home phone: Other phone:
 
3.
Employed (from) date: Employed (to) date:
Name of employer
Address: City, State, Zip:
Position:
If CNA or Companion, how old was your patient? years Patient was Male Female
If baby-sitter, how many children? Ages of children when started
Reason for leaving:
Contact person: Home phone: Other phone:
 
Please list age appropriate activities for the following ages:
Infant
Toddler
Younger children
 
Please provide any additional information, qualifications, experience etc.
 
Please state your philosophy on discipline and how you discipline child in your care
 
EDUCATION
High School:
Name and location
Did you graduate? Yes No
 
College or University:
Name and location(s)
Did you graduate? Yes No If yes, in what year?
Year(s) attended: Subject you majored in:
 
Other training and education:
 
Are you certified in CPR? Yes No  
 
Please give the names, addresses, and phone numbers of three persons not related to you whom you have known at least one year
1. Name:
Address:
Phone:
 
2. Name:
Address:
Phone:
 
3. Name:
Address:
Phone:
 
Have you ever been convinced of crime? Yes No
If yes, provide details:
 
HEALTH INFORMATION
Date of your last physical (medical) examination?
Have you had a TB test? Yes No If so, when? Results?
Have you been advised that you have any communicable diseases? Yes No
Do you smoke? Yes No Do you drink alcohol? Yes No Do you use drugs? Yes No
 
Are you currently taking any medication? Yes No
If yes, please explain:
Have you even been treated for drug or alcohol abuse? Yes No
If yes, please provide details:
Are you allergic to any medicines, animal, or insects? If so, specify:
 
Persons to call in an emergency:
1. Name Relation Phone
2. Name Relation Phone
3. Name Relation Phone

Pro Care Agency

Domestic Service Provider

APPLICANT AUTHORIZATION TO RELEASE RECORDS

INFORMATION

Complete Name

Number and Street

City

State

Zip Code

Drivers License Number
Birth Date

E-mail:

please scroll down to submit application

AUTHORIZATION

I hereby consent and authorize Pro Care Agency and any of its agents, including InfoTrack Information Services, Inc. to secure information pertaining to my character and background. I understand that the information supplied by me can be utilized in conducting a background investigation which may include, but not be limited, a consumer credit report, criminal history search, driving record history, and verification of any information as a result of this investigation. I further release companies and indemnify Pro Care Agency and InfoTrack Information Services, Inc against any liability that might result from conducting these investigations.

IMPORTANT

You are required by law to file with this agency a physical examination, which complies with the rules of the Illinois Department of Labor. All applicants to this agency must agree to obey this health regulation.

Applicant Certifies:

I certify the facts contained in this application are true and complete to the best of my knowledge and understand that, if I am employed, falsified statement on this application shall be ground to dismissal.

I authorize Pro Care Agency to confirm any or all of the information and references listed above .

Submission of this application implies that all information stated is true and complete to the best of my ability. I understand that omitting information or providing false information is grounds for immediate dismissal from employment as a nanny. I understand that I am using the services of Pro Care Agency. as a referral agency and I will not be considered an employee of Pro Care Agency. I agree that I will not travel to Employer's home until required agency fee has been received by Pro Care Agency. I understand that if I accept a position with any family referred by Pro Care Agency., I will notify Pro Care Agency. within 24 hours of acceptance. I understand that Pro Care Agency. acts solely as a facilitator and is not responsible, nor liable for any act of the Employer. I also agree to hold Pro Care Agency harmless and to indemnify Pro Care Agency from any and all claims, including attorney fees and court costs made by any person arising out of my employment as a nanny.