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Family Information

We do not discriminate on any factor including age, gender, race or ethnicity, religion, disability, military status, marital status, or the like.

Name

Phone

Email

Preferred contact

EmailPhone

Occupation

Does a parent work from home?

Yes, 1 parentYes, both parentsno

Do have any pets

Dog(s)Cat(s)Bird(s)FishBunnyOther

Are there any other adults in the home?

Family memberFriendShort-term renterLong-term renter

How did you hear about us?

Have you been a nanny before OR have you hired a nanny before?

Yes, I have hired a nannyNo, I haven't hired a nannyYes, I have been a nannyNo, I have not been a nanny

Child(rens)'s Information

Preferences for Nanny

Is travel required?

Yes, domesticYes, internationalNo

How long do you plan to employ a nanny

Just for travelA few weeksA few monthsUp to one yearLong-term (1 year +)

Desired schedule and hours for nanny

Salary expectations

Hourly wage

$20-$25 an hour$25-30 an hour$30-$35 an hour$40-$45 an hour$45-50 an hour$50-$55 an hour$60-$65 an hour$65 an hour +

Do you understand that you're required to withold taxes for a nanny?

Yes, I understandNo, I have decided to not hire a nanny

Are you providing any benefits?

PTOHealth insuranceDental insuranceEye insuranceFamily carHolidays off

Any you providing any other benefits?