APPLICATION – PARENTS

Temporary Service Placement

Clients of our temporary, baby sitting, and emergency childcare services, have access to our extensive network of screened and CPR certified caregivers. Whether you have an overnight business trip, your child is sick, your permanent caregiver is ill, or simply planning an evening out, Metropolitan Nannies can help.

In order to utilize Metropolitan Nannies’ Temporary Services, please complete the application form below.

Please review the fees and policies.

STEP 1 of 4: Temporary Service Application

Mother's First Name:

Mother's Last Name:

Occupation:

Place of Employment:

Work Phone:

Mobile Phone:

Email Address:

Father's First Name:

Father's Last Name:

Occupation:

Place of Employment:

Work Phone:

Mobile Phone:

Email Address:

Home Address:

Address Line 2:

City:

State:

Zipcode:

Home Phone:

Best Time to Call:

Best Person to Call:

Emergency Contact (Other than Parents):

Have you ever employed a babysitter or nanny? Have you ever employed a babysitter or nanny? Yes No

If yes, please describe relationship:

I am interested in Metropolitan Nannies for (check all that apply): I am interested in Metropolitan Nannies for (check all that apply): Sick Childcare Backup Card Around the Clock Care As-Needed Childcare Evening Sitting 1-8 Week Placement

YOUR CHILDREN: Please describe your children below:

Child #1 Name:

Child #1 Birthdate (Month/Day/Year):

Child_#1 Gender: Child_#1 Gender: Male: Female:

Child #1 School Hours:

Child #2 Name:

Child #2 Birthdate (Month/Day/Year):

Child_#2 Gender: Child_#2 Gender: Male: Female:

Child #2 School Hours:

Child #3 Name:

Child #3 Birthdate (Month/Day/Year):

Child #3 Gender: Child #3 Gender: Male: Female:

Child #3 School Hours:

Child #4 Name:

Child #4 Birthdate (Month/Day/Year):

Child #4 Gender: Child #4 Gender: Male: Female:

Child #4 School Hours:

Will you be present when the caregiver is with your children? Will you be present when the caregiver is with your children? Yes No

FAMILY PETS: Please list below any pets that you have in the home:

Pet #1 Name:

Pet #1 Type/Breed:

Please list any important information that we should know about this pet::

Pet #2 Name:

Pet #2 Type/Breed:

Please list any important information that we should know about this pet::

Pet #3 Name:

Pet #3 Type/Breed:

Please list any important information that we should know about this pet::

Pet #4 Name:

Pet #4 Type/Breed:

Please list any important information that we should know about this pet::

Do any other family members or friends live in your home (e.g. grandparents)? Do any other family members or friends live in your home (e.g. grandparents)? Yes No

Will they be there when the caregiver is present? Will they be there when the caregiver is present? Yes No

IF YES...Please list family members and/or friends below:

Name:

Relation to Family:

Please describe situation:

Name:

Relation to Family:

Please describe situation:

Name:

Relation to Family:

Please describe situation:

Name: