Pets Indoors:

Please explain any flexibility you need with your schedule:

Please explain any travel requirements with this job:

Does either parent work at home?: Yes No

If yes, please explain:

Please describe your salary and benefits package:

Health Insurance stipend:
$150/month
$100/month
Other:

Vacation and Holiday Time:
Family will continue to pay the nanny's salary when we are out of town or she is not needed.  This will provide at least paid days off a year.

Number of days per year for nanny's paid personal time off:

Paid legal holidays will include Memorial Day, 4th of July, Labor Day, Thanksgiving, Christmas, New Year's Day, and:

Do you provide a car? Yes No

Does your family employ a housekeeper weekly bi-weekly

Please describe the housekeeping/ cooking responsibilities that are needed for your children:

Please describe any additional household responsibilities:

What forms of childcare have you used in the past? Have these been good childcare experiences?:

How long do you plan to employ a nanny for your family?

Please describe your child's typical daily schedule:

Please describe the activities that your children are involved in
on a regular basis (friends, outings, classes, etc.):

Which of these activities does the nanny take charge of?:

What is your child's school schedule? Transportation Requirements?:

Please describe your home/yard/street/neighborhood for the nanny:

What modes of discipline do you use? Are there specific behavioral
conditions that the nanny should know about?:

Is any child or anyone in your household under the care of a physician
or mental health professional for any physical, emotional, developmental, or behavioral issues?:*
Yes No

If yes, please explain and list any special care, allergies and/or medications:

What will a nanny appreciate most about your family?:

What should we know that would help make a successful placement?:

I have read and agreed to the Permanent Placement Service Contract terms and conditions, understand and agree to accept them.*