Open Site Navigation
The Nanny Source Logo

Personal Information

Thanks for Applying!

Experience & References

Family 1

Family 1 Age of Children *

arrow&v
arrow&v

Family 2

Family 2 Children's Age Range

arrow&v
arrow&v

Family 3

Family 3 Children's Age Range

arrow&v
arrow&v

Education & Training

Additional Training & Interests

BY LAW YOU CANNOT BE REQUIRED TO ANSWER ANY OF THE FOLLOWING QUESTIONS THAT ARE STARRED UNTIL AFTER YOU HAVE BEEN PLACED, BUT PROVISION OF THE INFORMATION MAY BE USEFUL IN EXPEDITING OUR ABILITY TO PLACE YOU PROMPTLY, IF YOU CHOOSE TO PROVIDE IT.

arrow&v
Do you have children?

What is the age range of your children?

arrow&v
arrow&v
Do you drink alcohol?
Do you smoke?
Do you swim?
Have you ever been convicted for physically abusing children?

DISCLAIMER

 

IN ORDER TO SEND YOU OUT TO INTERVIEWS THIS PAGE MUST BE SIGNED I CERTIFY THAT ALL ANSWERS PROVIDED BY ME ON THE PLACEMENT APPLICATION ARE TRUE, CORRECT, AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND THAT NO FACTS HAVE BEEN OMITTED.

 

I AUTHORIZE THE NANNY SOURCE AND PROSPECTIVE EMPLOYERS, TO OBTAIN AN INVESTIGATIVE REPORT CONTAINING INFORMATION ABOUT ME, INCLUDING INFORMATION OBTAINED THROUGH PERSONAL INTERVIEWS WITH MY NEIGHBORS, FRIENDS AND ACQUAINTANCES. THIS REPORT MAY INCLUDE INFORMATION AS TO MY CHARACTER, GENERAL REPUTATION, CRIMINAL HISTORY, MOTOR VEHICLE RECORD AND WORKMAN'S COMPENSATION HISTORY.  IF FURTHER AUTHORIZE ACCESS TO INFORMATION REGARDING MY RELIABILITY, EMPLOYMENT HISTORY, AND DOCTOR AND HOSPITAL RECORDS. I AUTHORIZE THE NANNY SOURCE, TO ACCESS MY CONSUMER CREDIT REPORT. I UNDERSTAND THAT ANY NEGATIVE INFORMATION OBTAINED IN THESE INVESTIGATIONS MAY AFFECT, AS ALLOWED BY LAW, MY EMPLOYMENT ELIGIBILITY, BUT THAT ALL INFORMATION WILL BE EVALUATED IN LIGHT OF MY AGE AT THE TIMES OF AN INCIDENT, AND MY MODE OF LIVING SINCE THE INCIDENT OCCURRED. I UNDERSTAND THAT COMPLETION AND PROCESSING OF THIS APPLICATION DOES NOT OBLIGATE THE NANNY SOURCE TO EITHER HIRE OR PLACE ME IN ANY POSITION. I FURTHER AUTHORIZE THE NANNY SOURCE TO DISTRIBUTE, COPY, TRANSMIT AND FAX, AS ALLOWED BY LAW, THE INFORMATION ABOUT ME TO POTENTIAL EMPLOYERS, AND TO ACT AS MY AGENT IN SEEKING POTENTIAL EMPLOYMENT FOR ME. I UNDERSTAND THAT I WILL BE EXPECTED TO PAY MY AIR FARE AND/ OR OTHER TRAVEL EXPENSES IF I WANT TO RELOCATE TO ACCEPT A JOB UNLESS PRIOR ARRANGEMENTS HAVE BEEN MADE BETWEEN THE EMPLOYER AND MYSELF. I UNDERSTAND THAT UPON, PLACEMENT, MY EMPLOYER AND I ARE RESPONSIBLE TO THE IRS FOR ALL TAX OBLIGATIONS ARISING OUT OF MY EMPLOYMENT AND THAT I AM NOT AN EMPLOYEE OF THE NANNY SOURCE. I AGREE TO HOLD THE NANNY SOURCE HARMLESS, FROM ANY CLAIMS AGAINST IT RESULTING FROM MY CONDUCT, AND I AGREE TO FULLY INDEMNIFY THE NANNY SOURCE FOR ALL CLAIMS FOR DAMAGES DIRECTLY OR INDIRECTLY RESULTING BECAUSE OF MY ERRORS AND/OR OMISSIONS. I FURTHER RELEASE THE NANNY SOURCE, FROM ALL CLAIMS FOR PERSONAL INJURIES AND DAMAGES AS A RESULT OF THIS PLACEMENT, INCLUDING CLAIMS CAUSED BY THE ALLEGED NEGLIGENCE OF THE NANNY SOURCE. IAGREE TO NOTIFY THE NANNY SOURCE PROMPTLY OF EACH CONTACT WITH A PROSPECTIVE EMPLOYER TO WHOM I HAVE BEEN REFERRED, INCLUDING MY ACCEPTANCE OF ANY POSITION. I WILL NOT ACCEPT ANY OFFERS OF EMPLOYMENT FROM NANNY SOURCE CLIENTS WITHOUT GOING THROUGH THE NANNY SOURCE PROCESS OF HIRING, NOW OR AT ANY TIME IN THE FUTURE. I UNDERSTAND THAT IF I AM ON A JOB PROVIDED BY THE NANNY SOURCE AND ASKED TO LEAVE THE JOB BECAUSE THE NANNY SOURCE FEE HAS NOT BEEN PAID BY THE CLIENT, I WILL DO SO. I UNDERSTAND THAT IF I REFUSE TO LEAVE THE JOB I WILL BE RESPONSIBLE TO PAY THE AGENCY FEE IN FULL. I UNDERSTAND THIS COMMITMENT BY ME IS THE ESSENCE OF THE NANNY SOURCE'S AGREEMENT TO REPRESENT ME.

 

 

BY CLICKING ON THE SUBMIT BUTTON, YOU HEREBY SIGNING THIS DOCUMENT.

Select services offered
Upload File
Upload Video
Family 1 Sex of Children
Family 1 Live In/Live Out
Family 2 Sex of Children
Family 2 Live In/Live Out
Family 3 Sex of Children
Family 3 Live In/Live Out
Additional Training
Interests
Do you own a car?
Have you ever been convicted of a DUI?
arrow&v
Are you Trustline Registered in the State of California?
Are you registered with any other agencies?

apply today