Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you over 19 years of age? *

Yes

No

Desired Summer Position

Check all that apply. Please note: This for summer nannies ONLY! If you would like a long-term position, please fill out the correct form. Please do not fill out two separate forms.

Summer - Full-time Nanny

Summer - Part-time Nanny

Summer - On-call Nanny/Babysitter

Temporary - less than a year

Would you be willing to work weekends?

Yes

No

Please check the age groups you prefer to care for: *

Newborn (0-3 months)

Infants (3 to 12 months)

Toddlers ( 1 to 3 years old)

School Age (4 to 8 years old)

School Age (8 to 12 years old)

Teenagers (13 and up)

Are you willing to drive while working? *

Yes, with my car.

Yes, with family car only.

Yes, with either my car or family car.

No