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Family Application
Start Your Search for a
Nanny or Family Assistant
We Would Love to Hear from You!
Please complete the form below.
1
Personal Info
2
Work Info
3
Schedule Info
4
Nanny Info
5
Children Info
Your Information
First and Last Name
(Required)
First
Last
Email
(Required)
Home Phone Number
Cell Phone Number
(Required)
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Partner's Information
Partner's First and Last Name
(Required)
First
Last
Partner's Email
(Required)
Would you like your partner to be copied on all email correspondence?
(Required)
Yes
No
Partner's Contact Phone Number
(Required)
Your Information
Occupation
(Required)
Place of employment
(Required)
Work Phone Number
Hours worked per week?
(Required)
Do you work from home?
(Required)
Yes
No
Do you travel for work?
(Required)
Yes
No
Partner's Information
Partner's Occupation?
(Required)
Partner's Place of employment
(Required)
Partner's hours worked per week?
Does your partner work from home?
(Required)
Yes
No
Does your partner travel for work?
(Required)
Yes
No
Type of Nanny or Family Assistant you are applying for:
Work Hours?
(Required)
Full-Time (35 or more hours per week)
Part-Time (30 to 34 hours per week)
When would you like Nanny or Family Assistant to start?
(Required)
MM slash DD slash YYYY
Is your start date flexible? If so, please detail if you are able to have your Nanny or Family Assistant start ealier or later than the date listed, and by how many days/weeks.
Special skills requested:
(Required)
Newborn experience
Cooking
Homework help
Swimming
Special needs
Driving on the job
Family Assistant related skills (list below)
Please list what skills your Family Assistant position will require.
(Required)
If you requested "swimming" above as a special skill, is this preferred or a required?
Preferred
Required
Nanny's/Family Assistant's weekly work schedule:
Monday Start Time:
Hours
:
Minutes
AM
PM
AM/PM
Monday End Time:
Hours
:
Minutes
AM
PM
AM/PM
Tuesday Start Time:
Hours
:
Minutes
AM
PM
AM/PM
Tuesday End Time:
Hours
:
Minutes
AM
PM
AM/PM
Wednesday Start Time:
Hours
:
Minutes
AM
PM
AM/PM
Wednesday End Time:
Hours
:
Minutes
AM
PM
AM/PM
Thursday Start Time:
Hours
:
Minutes
AM
PM
AM/PM
Thursday End Time:
Hours
:
Minutes
AM
PM
AM/PM
Friday Start Time:
Hours
:
Minutes
AM
PM
AM/PM
Friday End Time:
Hours
:
Minutes
AM
PM
AM/PM
Saturday Start Time:
Hours
:
Minutes
AM
PM
AM/PM
Saturday End Time:
Hours
:
Minutes
AM
PM
AM/PM
Sunday Start Time:
Hours
:
Minutes
AM
PM
AM/PM
Sunday End Time:
Hours
:
Minutes
AM
PM
AM/PM
Please list any scheduling notes, such as what is flexible or not, or upcoming changes.
Hourly Salary Range:
Minimum
(Required)
Maximum
(Required)
If homework help is desired, what grade, which subject(s)?
If other language(s)/ASL desired, which language(s)?
Have you ever employed a Nanny or Family Assistant?
(Required)
Yes
No
How was your experience?
(Required)
Please describe your idea of what you would like your Nanny or Family Assistant to do on a typical day.
(Required)
Please describe what kind of parents you are, and your lifestyle.
(Required)
What do you do as a family in your free time?
(Required)
Will you need your Nanny or Family Assistant on your vacation?
(Required)
Yes - Preferred
Yes - Required
No
How often do you vacation and where?
(Required)
Will summer change the schedule for your Nanny or Family Assistant?
(Required)
Yes
No
Possibly
Please describe what the summer schedule will be.
Will you require your Nanny or Family Assistant to care for sick children?
(Required)
Yes
No
Possibly
Which of the following are most important to you as your Nanny's or Family Assistant's duties?
(Required)
Keep children entertained and engaged
Help with homework
Creative and educational games and playtime
Bath Time and nap/sleep routine
Transporting children to and from school, activities, etc.
Light housekeeping (related to children only)
Children's laundry
Preparing children's meals and snacks
Grocery shopping and occasional errands
Personal Assistant work
House management and overseeing other employees
Please list five qualities that are important to you in a Nanny or Family Assistant:
1) Quality important to you in a Nanny or Family Assistant:
2) Quality important to you in a Nanny or Family Assistant:
3) Quality important to you in a Nanny or Family Assistant:
4) Quality important to you in a Nanny or Family Assistant:
5) Quality important to you in a Nanny or Family Assistant:
Please list any additional information or responsibilities specific to your family situation that the nanny or Family Assistant should be aware of.
How many children to you have?
(Required)
Please Select
1
2
3
4
5
Children 1 Details
Child 1 First and Last Name
(Required)
First
Last
Child 1 Gender
(Required)
Male
Female
Child 1 Age (months or years)
(Required)
Child 1 Date of Birth
Briefly describe your child.
(Required)
Children 2 Details
Child 2 First and Last Name
(Required)
First
Last
Child 2 Gender
(Required)
Male
Female
Child 2 Age (months or years)
(Required)
Child 2 Date of Birth
Briefly describe your child.
(Required)
Children 3 Details
Child 3 First and Last Name
(Required)
First
Last
Child 3 Gender
(Required)
Male
Female
Child 3 Age (months or years)
(Required)
Child 3 Date of Birth
Briefly describe your child.
(Required)
Children 4 Details
Child 4 First and Last Name
(Required)
First
Last
Child 4 Gender
(Required)
Male
Female
Child 4 Age (months or years)
(Required)
Child 4 Date of Birth
Briefly describe your child.
(Required)
Children 5 Details
Child 5 First and Last Name
(Required)
First
Last
Child 5 Gender
(Required)
Male
Female
Child 5 Age (months or years)
(Required)
Child 5 Date of Birth
Briefly describe your child.
(Required)
Additional Household Information
Do you have any household pets?
(Required)
Yes
No
Please list the type and size of any household pets. If you do not have any pets please list N/A.
(Required)
Is your household:
(Required)
Smoking
Non-Smoking
Do you have a housekeeper?
(Required)
Yes
No
How did you hear about us?
(Required)
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Packages & Gifts
Childcare
Baby Doula Services
Newborn Care Specialist Services
Night Nanny Services
Postpartum Doula Services
Babysitting Services
Nanny Placement
Family Assistant Placement
Governess Placement
House Manager Placement
Become A Nanny
Become A Doula
Become A Night Nanny
Become A Newborn Care Specialist
Education
Pregnancy Classes
Pregnancy 101
Breastfeeding
Natural Childbirth
Labor Rehearsal
Prepared Childbirth
Newborn Care
Prenatal Nutrition
Parenting Classes
Parenting 101-102
Mama Circle
Infant Massage
Grandparent Refresher
Breastfeeding Nutrition
Introducing Solids
Family & Friends CPR
CPR Certification
New Mother School
Additional Classes
Rediscovering You
Private VIP Classes
Pregnancy & Motherhood
Massage Spa Services
Prenatal & Postnatal Massage
Swedish Massage
Deep Tissue Massage
In-Home or Hospital Massage
Hot Stone Massage
Labor Preparation Massage
Induction Massage
View All Massage Spa Services
Health & Wellness
Prenatal Yoga
Mom & Baby Yoga
Prenatal Fitness & Pilates
View All Yoga & Fitness Class
Motherhood Support
Maternity Consultation
New Mother School
Mama Circle
Mom & Baby Check-In
Sleep Coaching
Breastfeeding Support
Lactation Consultation
Breast Pump & Baby Scale Rental
Blog
About Us
Meet Gabriela Gerhart
Contact Us
In The News
Events
Phone: 713-963-8880
Jobs & Recruitment
Contact Us
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