Candidate

Step 1 - General Information
Full Name*

Include middle initial
Position Applied For*
Upload a Photo
Accepted file types: jpg, jpeg, gif, png, Max. file size: 10 MB.
Address*

Street, Apt, Unit #
City*
State*
ZIP*
Desired Salary
Date Available
MM slash DD slash YYYY
Email Address*
Home Phone
Work Phone
Cell Phone
Emergency Contacts
Are you legally authorized to work in the US?
- Yes
- No
Have you ever been convicted of a crime?
- Yes
- No
If convicted, explain
Do you have your own dependable transportation?
- Yes
- No
Are you willing to transport children in your car with gasoline reimbursement from employer?
- Yes
- No
List any offenses that appear on your driving record for the last seven years. This will include all moving and non moving violations.
Example: Speeding tickets, accidents, stop signs/red lights, etc. Please contact NannyQuest with questions or obtain a copy of your seven year driving record from your local police department.

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Step 3 - Previous Employment
Please do not leave gaps in employment history. Include any related volunteer work.
Most Recent
Company
Address
Phone
Job Title
Supervisor
Email
Responsibilities
Reason for Leaving
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
May we contact your previous supervisor for a reference?
- Yes
- No
Next Recent
Company
Address
Phone
Job Title
Supervisor
Email
Responsibilities
Reason for Leaving
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
May we contact your previous supervisor for a reference?
- Yes
- No
Next Recent
Company
Address
Phone
Job Title
Supervisor
Email
Responsibilities
Reason for Leaving
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
May we contact your previous supervisor for a reference?
- Yes
- No

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Step 5 - Childcare / Household Staffing References
Please list four references. Do not list family or friends.
Reference 1

Do not repeat references listed above.
Name
Company
Number of children cared for
Ages of children
What type of position?
Reason for leaving
Relationship
Phone
Email
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Approximate hours worked weekly.
Reference 2

Do not repeat references listed above.
Name
Company
Number of children cared for
Ages of children
What type of position?
Reason for leaving
Relationship
Phone
Email
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Approximate hours worked weekly.
Reference 3

Do not repeat references listed above.
Name
Company
Number of children cared for
Ages of children
What type of position?
Reason for leaving
Relationship
Phone
Email
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Approximate hours worked weekly.
Reference 4

Do not repeat references listed above.
Name
Company
Number of children cared for
Ages of children
What type of position?
Reason for leaving
Relationship
Phone
Email
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Approximate hours worked weekly.

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Step 7 - Housekeeping / Home Management
Do you have experience with the care of valuable china, crystal, marble floors, etc.?
Will you sweep outside and clean off patio furniture?
Do you iron?
- Yes
- No

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Step 8 - Your Health
Do you smoke?
- Yes
- No
Do you have any allergies, including those to pets?
Do you have any health conditions that would prohibit you from doing the job correctly?

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Step 9 - Personal Profile
Tell us about yourself
Describe your philosophy of childhood discipline
Why do you wish to be a nanny / professional caregiver or household manager at this time in your life?
What do you, more than anyone else, have to offer a NannyQuest family?
What is your greatest strength?
Where do you see yourself in five years?
What is your greatest weakness?
Describe the most difficult time you have had with a child and tell us how you dealt with it
Terms and Conditions

By submitting this form I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Acceptance*
- I accept the terms and conditions
If you have included a photo to upload it may take a few seconds for uploading and processing. Click submit only once. You will receive a copy of this application via email.

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Step 1 - General Information