Caregiver Job Application Form

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Name

Nombre

Apellido

Phone Number

E-mail

If applying for a specific position, list the job title here:

Total number of years experience in childcare:

Address

Dirección

Ciudad

Estado / Provincia

Código postal

Date of Birth

I meet the following requirements (check all that apply):

Able to pass a background check Available for full-time work Non-smoker Have reliable transportation

Are you 21 years of age or older?

Yes No

Are you authorized to work In The United States?

Yes No

Are you currently living in the Greater Seattle Area?

Yes No

Where are you located?

Do You Own A Car?

Yes No

Do You Have A Drivers License?

Yes No

Areas you are comfortable commuting to:

Distance Willing To Travel?

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Introduce yourself to a prospective employer by sharing a personal letter about your experience. Include qualities that make you an outstanding nanny and why you've chosen this profession:

List three words that describe your personality:

What skills and experience do you have that are useful for nannying? Feel free to be as in depth as possible.

CPR/First Aid Certified?

CPR/First Aid Expiration Date

Name of CPR/FA instructor:

Phone number for CPR/FA instructor:

Can You Swim?

List any additional health & safety trainings:

Anything else you would like to share:

Include links to your social media profiles, so we can get to know you better:

OPTIONAL: Upload a recent photo of yourself (5MB or smaller gif, png, jpg, or jpeg file)

Max 10 MB per file

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Highest Level of Education:

High School

Graduated High School?

Additional Notes

College

Graduated College?

Number of Years Attended College

College Area of Study/Degree

Additional Notes

Graduate School

Graduated Grad School?

Number of Years Attended

Area of Study/Degree

Additional Notes

Trade School/Other

Graduated From Trade School?

Number of Years Attended

Area of Study/Degree

List of other professional training:

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May we contact your references?

Yes No

Reference One

Reference One Relationship

Reference One Years Acquainted

Reference One Phone

Reference One Email

Additional Notes

Reference Two

Reference Two Relationship

Reference Two Years Acquainted

Reference Two Phone

Reference Two Email

Additional Notes

Reference Three

Reference Three Relationship

Reference Three Years Acquainted

Reference Three Phone

Reference Three Email

Additional Notes

Reference Four

Reference Four Relationship

Reference Four Years Acquainted

Reference Four Phone

Reference Four Email

Additional Notes

Reference Five

Reference Five Relationship

Reference Five Years Acquainted

Reference Five Phone

Reference Five Email

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Please Upload Your Cover Letter

Max 10 MB per file

Please Upload Your Resume

Max 10 MB per file

Acknowledgement

I certify that the information provided is true and accurate

Caregiver Job Application Form

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