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–
Step
1
of 4
Email
*
Parent name
*
First
Last
Phone number
*
Additional parent name
First
Last
Additional parent phone number
Address
*
Address Line 1
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Dates of services needed
*
Days and hours needed:
*
Example: M 7:00am-4:30pm, T 10am-4:15pm
Please share your hourly rate budget
*
How long do you need nanny services for?
*
Are you using any other resources for your nanny search?
*
Services I am interested in
*
Ongoing services / Babysitting membership
Emergency support
Other
Number of children
*
1
2
3
4+
5+
Next
First Child
First Child: Name and age
*
First Child: Childs birthdate
*
First Child: Gender
*
Male
Female
First Child: COVID-19 vaccinated
*
Yes
No
First Child: Potty trained
*
Yes
No
Other
First Child: Allergies
*
Please list type of allergy (food, medication, animal) , reaction and treatment.
First Child: Special diet / dietary restrictions
*
Example: vegetarian, dislikes broccoli, etc.
First Child: Describe personality and temperament
*
First Child: Health or behavior concerns
*
Examples: ADHD, low weight, autism, etc.
First Child: Likes and dislikes
*
First Child: Favorite toy, thing to do, or play
*
First Child: Fears
*
First Child: Daily schedule (school, naps, food simple description)
*
Second Child
Second Child: Name and age
*
Second Child: Childs birthdate
*
Second Child: Gender
*
Male
Female
Second Child: COVID-19 vaccinated
*
Yes
No
Second Child: Potty trained
*
Yes
No
Other
Second Child: Allergies
*
Please list the allergy, reaction and treatment for each.
Second Child: Special diet / dietary restrictions
*
Example: vegetarian, dislikes broccoli, etc.
Second Child: Describe personality and temperament
*
Second Child: Health or behavior concerns
*
Examples: ADHD, low weight, autism, etc.
Second Child: Likes and dislikes
*
Second Child: Favorite toy, thing to do, or play
*
Second Child: Fears
*
Second Child: Daily schedule (school, naps, food simple description)
*
Third Child
Third Child: Name and age
*
Third Child: Childs birthdate
*
Third Child: Gender
*
Male
Female
Third Child: COVID-19 vaccinated
*
Yes
No
Third Child: Potty trained
*
Yes
No
Other
Third Child: Allergies
*
Please list the allergy, reaction and treatment for each.
Third Child: Special diet / dietary restrictions
*
Example: vegetarian, dislikes broccoli, etc.
Third Child: Describe personality and temperament
*
Third Child: Health or behavior concerns
*
Examples: ADHD, low weight, autism, etc.
Third Child: Likes and dislikes
*
Third Child: Favorite toy, thing to do, or play
*
Third Child: Fears
*
Third Child: Daily schedule (school, naps, food simple description)
*
Fourth Child
Fourth Child: Name and age
*
Fourth Child: Childs birthdate
*
Fourth Child: Gender
*
Male
Female
Fourth Child: COVID-19 vaccinated
*
Yes
No
Fourth Child: Potty trained
*
Yes
No
Other
Fourth Child: Allergies
*
Please list the allergy, reaction and treatment for each.
Fourth Child: Special diet / dietary restrictions
*
Example: vegetarian, dislikes broccoli, etc.
Fourth Child: Describe personality and temperament
*
Fourth Child: Health or behavior concerns
*
Examples: ADHD, low weight, down syndrome, etc.
Fourth Child: Likes and dislikes
*
Fourth Child: Favorite toy, thing to do, or play
*
Fourth Child: Fears
*
Fourth Child: Daily schedule (school, naps, food simple description)
*
Next
Household Information
Describe household personality in your own words. i.e. playful, easygoing, detail oriented, structured
*
Places near by the nanny is allowed to take child
*
Short description of parents personalities
*
Household pet peeve
*
Are there any particular rules in your home that needs to be followed? i.e. shoe's off, dog off the couch, children not allowed TV?
*
Pets breed, name, personality
*
Are all adults vaccinated for COVID-19?
*
Yes
No
Other
Additional information we need to know
*
Next
Your Ideal Nanny
Does this position request the nanny to transport your child?
*
No
Yes – Nanny Use Own Vehicle
Yes – Family Will Provide Vehicle
Describe ideal personality of your nanny
*
Do you have any deal breakers
*
Do you have any special request
*
Is there anything else you would like to share that we need to know
*
Please share with us your Covid-19 protocols and what safety precautions you will request from your nanny
*
Submit