Your Name *
Your Name
Name of Spouse/Partner
Name of Spouse/Partner
Phone *
Alternate Phone
Alternate Phone
Address *
Is your home accessible to public transportation? *
If yes, which train or bus line?
Are you interested in a home consultation or only by phone? *
Does your family have a pet?
If yes, please describe:
Does your nanny need to care for your pets?
What type of nanny are you looking for?
Desired start date of nanny, if any?
Desired start date of nanny, if any?
Are you open to a manny?
May we contact her/him?
If yes, current nanny's name?
Current nanny's number?
What household responsibilities are required of the nanny?
Check all that apply
What from this list--which is NOT part of a nanny's regular duty--should be negotiated between the family and the nanny?
Check all that apply
If other, please specify:
Is driving required of your nanny?
Include their gender and age
Do you believe in lots of discipline? Or are you more permissive? (if applicable)
Family hobbies? Interests?
Are you interested in setting up a nanny work agreement?