Nanny Client Application

"*" indicates required fields

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Client Information

Client's name*

Client's first name Client's last name

Occupation

Employer

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Are there any special directions to find the home?*

(e.g. hidden drive, landmarks, security gate)

Phone number type*

Phone*

Email*

Enter Email Confirm Email

Partner's name

Partner's first name Partner's last name

Occupation

Employer

Phone

Search lead name

(e.g. who will be leading the search for this role if different than client)

Phone

Who will make the hiring decision?*

Is this role associated with an organization (e.g. business, LLC, conservatorship)*

Yes

If yes, please provide the organization's name:

Who should be copied on search correspondence?*

If there are children in the home, please lis each child's name, sex, and Date of birth, allergies, and any schedule considerations:*

Name

Gender

Date of birth

Allergies

Schedule considerations

Are you expecting?*

Yes

If yes, when are you due?

MM slash DD slash YYYY

Are there other adults in the home?*

Yes

If yes, please list their names and ages:

Name

Age

Are there pets in the home?*

Yes

If yes, please provide the following information:

Name

Breed

Age

Weight

How did you hear about us?*

Candidate referral

Client referral

Community marketing outreach

Corporate employer program

Email marketing

Event planner

Friend

Hotel partner

Marketing advertisement

Moms group

Returning client

Returning candidate

School partner

Social media (IG, FB)

T+C website

Trusted business partner

Other

If referred, please indicate by whom so we can thank them:

Job Description

Is this a confidential search?*

Yes

Type of childcare professional you are seeking:*

Family Assistant

Nanny

Overnight Nanny

(please specify at least one):

Type of position you are seeking:*

Full-time

Part-time

Live-in

Live-out

Long-term

Temporary

Start date:

MM slash DD slash YYYY

End date

MM slash DD slash YYYY

(if applicable)

Days and hours needed:*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Which time frame would you like coverage for each day of the week?*

Same time each day

Different times each day

If so, please specify the time.

If you prefer different coverage time frames for each day, please specify the times for each day below.

Comments:

Please indicate any additional details about your preferred start or end date.

Will overtime and weekends be required?*

Yes

If yes, how often?

Will the candidate for this position be required to work holidays?*

Yes

If yes, please specify?

Is there any other information we should know about the required schedule?

Is a uniform required or do you have a preferred dress code?*

Yes

If yes, please describe:

Would you consider a nanny who wanted to bring their pet to work?

Yes

Is there anyone currently employed in this position?*

Yes

If yes, please describe the situation:

Will the employee be required to travel?*

Yes

If yes, please list frequency, destinations, and responsibilities while traveling:

Do you have a preferred language skillset?*

Yes

If yes, please explain:

Core Responsibilities

What duties will the employee be expected to perform?*

(Check all that apply)

Attend children's classes and activities

Childcare

Children's event planning

Children's laundry

Cooking for children

Driving children

Homework help

Light housekeeping

Managing family calendar

Personal shopping

Purchasing children's items

Running errands

Scheduling appointments

Tech savvy; apps, email, text

Secondary Responsibilities

In addition to their specific job responsibilities, please check secondary job duties:*

(check all that apply)

Cooking

Family event planning

Family laundry

Grocery shopping

Meal prep

Scheduling vendors

Washing dishes

Vehicle maintenance

Will pet care be required?*

Yes

If yes, please check all that apply:

Cleaning up after

Feed

Walk

Take to appointments

Is there any other information we should know about the duties to be performed?

Please describe your ideal candidate (e.g. level of experience, education, personality)*

Are there any special needs (physical, emotional, or medical) we should know about?*

Yes

If yes, please provide more details:

Additional comments:

Household Environment

Please describe your home*

(e.g. size, formal, casual, house, apt):

Will the candidate be required to swim?*

Yes

Do you employ other domestic help?*

Yes

If yes, please list titles, responsibilities, and schedule:

Do you and or your partner work from home?*

Yes

If yes, how often?

Will parking be provided?*

Yes

If yes, please describe:

Is there any special information the employee should know about parking near your house?

Will the employee be required to drive?*

Yes

If driving is required, will the employee need their own car for the job?

Candidate must have their own car

We can provide a car, if needed

We will provide a car, and the employee should use that car for the job

If a car is provided:

(The car provide is:)

Manual

Automatic

Electric

If this is a live-in position, please describe quarters:

Detached cottage

Room in a house with private bath

Room and bath with separate entrance

Room in house with shared bath

Additional information about living quarters:

Describe a typical day for the employee*

Compensation and Benefits

Salary range: (based on duties and experience of the candidate)

Exempt (salaried positions) or non-exempt (hourly):*

Exempt

Non-exempt

From $*

To $*

Benefits to be provided:

Paid sick days (# of days)

Paid holidays (# of paid holidays)

Paid vacation (# of vacation days)

(check all that apply)

Please indicate amount:

Your placement counselor will provide additional guidance about competitive benefits.

Medical insurance:*

Yes

Medical insurance - If yes

Health care benefit

Stipened

$ amount

Please indicate amount:

Your placement counselor will provide additional guidance about competitive benefits.

Retirement plan*

Yes

Cell phone*

Yes

Commuter reimbursement*

Yes

Other

Would you like a referral for a payroll provider?*

Yes

Personal Information

Do you require current vaccination?*

Yes

If yes, please check all that apply:

Flu (annually)

COVID

DTap (whooping cough)

MMR

Communication Preferences

What is the best way to communicate with you about your search:*

Texting

Phone

How would you like your candidate to communicate with you?*

Texting

Phone

(select all that apply)

Our Contract with You

The terms and conditions under which Town + Country Resources, Inc. will provide its services to you are shown below. By ticking "I have read and agree to the above terms and conditions" and clicking "Agree and send," this will become our written contract signed by you. You will receive an email copy of this contract at the email you provided above.

Authorization*

I am authorized to execute this agreement on behalf of the company named above

Agreement*

I have read and agree to the above Town + Country terms and conditions, Privacy Policy and Terms of Use

This field is for validation purposes and should be left unchanged.

Nanny Client Application

Client Information

Job Description

Core Responsibilities

Secondary Responsibilities

Household Environment

Compensation and Benefits

Personal Information

Communication Preferences

Our Contract with You

Enhance your home and enrich your life with Town + Country Resources

Contact Info

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