Nanny Application

White House Nannies Inc. Initial Employment Application Form

SPECIAL NOTE: Please complete the application in its entirety. We are trying to anticipate what your potential employers will want to know. If you choose not to answer some questions, it is acceptable to write "no answer." However, the application and all other documents provided are proprietary to White House Nannies, Inc. and are registered and copyrighted. If you decide not to apply we will hold your application as incomplete or destroy it, as you wish.

Date Completed:
Position Type:
- Long-Term Placement Live-Out
- Long-Term Placement Live-In
- Nanny/ Household Manager Live-Out
- Nanny/ Household Manager Live-In
- Temporary Service
- Summer Nanny (May-August)
- Newborn Specialist
Name:
FirstLast
Address:
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Home Phone:
Cell Phone:
Email:
Maiden Name:
Other Names Used:
How long have you been at this address?
Nearest Friend or Relative:
FirstLast
Phone:
What is the highest level you completed in school?
Name of High School:
Name of College:
Major:
Have you ever applied to White House Nannies, Inc?
- Yes
- No
If so, under what name and what year?
How did you hear about White House Nannies?

Why are you interested in childcare work?
How would you describe your personality?
What are your long-term job or career goals?
What are some of your hobbies or interests?
Tell us about any travel experiences you have had:
What other commitments do you have? (Please include any current or up-coming commitments, i.e. school, full or part-time jobs, major travel plans, etc.)

Employment References
LIST ALL EMPLOYMENT HISTORY PERTAINING TO CHILDCARE FOR THE LAST 10 YEARS. START WITH YOUR CURRENT OR LAST JOB. (Please include any business references so that we can establish a work chronology).
Reference 1
Employer Name:
Address:
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone:
Dates Employed:
Position Held:
Starting Salary:
Ending Salary:
If childcare, ages of children:
Responsibilities:
Reason for leaving:
Can we contact this employer?
- Yes
- No
If NO, please explain:
Reference 2
Employer Name:
Address:
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone:
Dates Employed:
Position Held:
Starting Salary:
Ending Salary:
If childcare, ages of children:
Responsibilities:
Reason for leaving:
May we contact this employer?
- Yes
- No
If NO, please explain:
Reference 3
Employer Name:
Address:
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone:
Dates Employed:
Position Held:
Starting Salary:
Ending Salary:
If childcare, ages of children:
Responsibilities:
Reason for leaving:
May we contact this employer?
- Yes
- No
I CERTIFY THAT THE ANSWERS GIVEN HEREIN AND THE INFORMATION PROVIDED ARE FACTUAL, TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT FALSIFICATIONS, OMISSIONS OR MISREPRESENTATIONS MAY BE CAUSE FOR REJECTION OF MY APPLICATION TO WHITE HOUSE NANNIES, INC. OR ANY OF ITS CLIENTS, AND IF EMPLOYED BY A CLIENT OF WHITE HOUSE NANNIES, INC. MAY BE CAUSE FOR IMMEDIATE DISMISSAL IF DISCOVERED AFTER MY EMPLOYMENT. I AUTHORIZE INVESTIGATION OF ALL INFORMATION CONTAINED IN THIS APPLICATION AND ANY SUPPLEMENTAL MATERIAL SUPPLIED BY ME AS MAY BE NECESSARY. I FURTHER AUTHORIZE ANY EMPLOYER, PERSON, CORPORATION, OR EDUCATIONAL INSTITUTION LISTED HEREIN, INCLUDING WHITE HOUSE NANNIES, INC., TO ANSWER ANY AND ALL QUESTIONS AND AGREE TO HOLD ALL PERSONS HARMLESS FOR PROVIDING ANY AND ALL INFORMATION WITHIN THEIR KNOWLEDGE OR RECORDS.

White House Nannies Inc. Initial Employment Application Form

Step 1 of 7

Rate yourself on the following qualities:

Employment References

Reference 1

Reference 2

Reference 3