Nanny Application Form

Please fill out and submit the form below.

First Name*

Middle Name*

Last Name*

List All Nicknames*

List any and all legal names used in the past*

Date of Birth*

age*

Current / Temporary Address*

City*

State*

Zip Code*

Permanent Address

City*

State*

Zip Code*

Cell Phone #*

E-mail*

Emergency Contact*

List all allergies:*

What is your current living situation?*

Are you legally permitted to work in the United States?

yes

no

unsure

Will your background check come back clear?*

Do you have a valid Drivers License?

yes

no

Do you have proof of Auto Insurance?

yes

no

What is the make / model / year of your vehicle you plan to drive to your Nanny job?*

Will your driving record come back clear?*

If you are qualified to be a teacher, are you interested in leading a Learning Pod during Covid-19

yes

no

Please list each family you have been a Nanny for*

Which family provided your best experience as a nanny, and why?*

Which, if any, proved to be less positive experiences for you as a nanny, and why? *

Why do you feel you would be a fantastic Nanny?*

Why are you seeking the assistance of our Agency?*

Have you been legally employed as a Nanny in the past?*

Use this space below to pitch yourself to our service*

Please describe your "Unicorn Family"*

How many children would you prefer to nanny?*

Where is your ideal job located?*

Are you willing to consider being Live-In Nanny?

yes

no

Are there any deal breakers?*

Are you currently employed as a Nanny, or otherwise?*

If you are currently employed, how much notice do you need to give?*

Please explain a few options for start dates*

What hours/days/weeks are you available to Nanny?*

What TERM of employment are you looking for? Select all that apply

PERMANENT & Full Time (>12 Weeks, 30+ hours/week)

PERMANENT & Part Time (>12 Weeks, 12-30 hours/week)

TEMPORARY & Full Time (2-12 Weeks, 30+ hours/week)

TEMPORARY & Part Time (2-12 Weeks, 12-30 hours/week)

Please select / agree to the following

I understand that I am seeking legal Employment as a Nanny and will pay taxes on my earnings

I will make myself available for an initial interview with My Boulder Nanny

I understand that I will need to interview with potential families

My Boulder Nanny will assist me in signing a contract with a Family if they offer me a job and I accept

I will do my best to uphold any and all comitments agreed to :)

Please provide a current photo of yourself.

Choose a file…