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703-759-3071
703-759-3071
The leading childcare placement
agency in the Washington DC area
for over 20 years
Employment Application
Nanny Application
First Name:
Last Name:
Home Address:
Address Line 2
City:
State:
Zip Code:
Home Phone:
Work Phone:
Mobile Phone:
Email Address:
Best Time to Call:
Emergency Contact:
What is your Gender?
Male
Female
Do you have a driver’s License?
Yes
No
Driver’s License Number:
Driver’s License State:
What is your age?
Start Date:
Geographic Areas Preferred (Which areas do you want to work?)
1
2
3
4
Desired Salary?
Availability: Permanent
Full Time
Part Time
Live Out
Live In
Summer / Short Term
Hours Available: Temporary
Week Days
Week Nights
Over Night
Weekends
Please check all duties that you are willing to perform related to the care of children:
Laundry
Bathing
Reading to Children
Feeding
Preparing Meals
Cleaning
Age-Approriate Activities
Other (please describe):
Please check all duties that you are willing to perform that are non-child related:
Housekeeping
Laundry
Errands
Cooking
Other (please describe):
Do you have experience with infant care?
Yes
No
Are you trained in Infant / Child CPR?
Yes
No
Are you willing to travel?
Yes
No
Do you know First Aid?
Yes
No
Are you willing to drive the children around?
Yes
No
If yes, do you have an insured car?
Yes
No
Car Make / Model
Can you swim?
Yes
No
Please describe your driving record:
Have you ever been arrested?
Yes
No
If yes, please describe the circumstances of your arrest:
Have you ever been convicted of a crime?
Yes
No
If yes, please describe the circumstances of your crime:
Would you work in a home with pets?
Yes
No
Do you smoke?
Yes
No
Employment History (Non-Childcare Related):
Employer 1
Business:
Supervisor’s Name:
Phone Number:
Can we contact?
Yes
No
Address:
City
State
Zip Code
Gross Salary (before taxes):
Start Date:
End Date:
Please describe your duties:
Reason for leaving:
Employer 2
Business:
Supervisor’s Name:
Phone Number:
Can we contact?
Yes
No
Address:
City
State
Zip Code
Gross Salary (before taxes):
Start Date:
End Date:
Please describe your duties:
Reason for leaving:
Employer 3
Business:
Supervisor’s Name:
Phone Number:
Can we contact?
Yes
No
Address:
City
State
Zip Code
Gross Salary (before taxes):
Start Date:
End Date:
Please describe your duties:
Reason for leaving:
Childcare References
Childcare Reference 1
Name:
Phone Number:
Can we contact?
Yes
No
Address:
City
State
Zip Code
Gross Salary (before taxes):
Start Date:
End Date:
Describe Children
Ages
1
2
3
4
Gender
Male
Female
Male
Female
Male
Female
Male
Female
Please describe your duties:
Reason for leaving:
Childcare Reference 2
Name:
Phone Number:
Can we contact?
Yes
No
Address:
City
State
Zip Code
Gross Salary (before taxes):
Start Date:
End Date:
Describe Children
Ages
1
2
3
4
Gender
Male
Female
Male
Female
Male
Female
Male
Female
Please describe your duties:
Reason for leaving:
***
Childcare Reference 3
Name:
Phone Number:
Can we contact?
Yes
No
Address:
City
State
Zip Code
Gross Salary (before taxes):
Start Date:
End Date:
Describe Children
Ages
1
2
3
4
Gender
Male
Female
Male
Female
Male
Female
Male
Female
Please describe your duties:
Reason for leaving:
Why do you want to be a nanny?
What types of activities do you enjoy doing with children?
Please describe a typical day with a child you have been a care provide for?
Describe your personality.
What are your hobbies and interests?
What are your future goals?
Describe your discipline philosophy.
I am happiest when:
A bad day is when:
How did you hear about Metropolitan Nannies? (required)
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