A Brilliant Nanny | A Boutique Nanny Agency in Portland, Oregon

*Your Name

*Home Phone

Cell Phone

*Address

*City

*State

*ZIP

Email address

Occupation

Company name

Spouse or Partner's Name

Home Phone

Cell Phone

Address

City

State

ZIP

Email Address

Occupation

Company name

Best way to contact you

Child's Name

Date of birth
(yyyy-mm-dd)

Gender

Special needs, allergies, medicines:

Date you would like nanny to start
(yyyy-mm-dd)

Anticipated date of completion, if known
(yyyy-mm-dd)

Overnights Required

Travel/Vacations with the family

The nanny will primarily be home alone with the childrenhome with the children and one or more of the parents

The nanny will primarily be

Taxes and payroll will most likely be handled by

ClientPersonal AccountantNanny Tax and Payroll

Health benefits YesNo

Health benefits

If yes, dollar or percentage amount per month

Paid vacation YesNo

Paid vacation

Sick days per year

Nanny will be paid while family is on vacation or when her services are not required YesNo

Nanny will be paid while family is on vacation or when her services are not required

Tranportation Nanny will provide her own car and be reimbursed for mileageNanny will be provided a car

Tranportation

Type of car provided AutomaticManual

Type of car provided

Please list paid holidays

Any additional benefits

Nanny will be employed for 3 months6 months1 year

Nanny will be employed for

Other

I do NOT want my anonymous job posting to be visible to potential candidates on www.abnanny.com.

*How did you hear about us?

If referral or other

Pets (please specify animal type and breed)
Are pets indoor/outdoor?

IndoorOutdoor

Please describe any allergies any of your children have

Please describe any and all activities your children are involved in

Will the nanny be responsible for managing any of the above activities? Please explain

Are there any other household duties other than childcare you would like the nanny to help you with? Please Explain

What would you like a potential nanny to know about your family

Please describe any forms of childcare you have used in the past

Please list some qualities that you feel would best describe your ideal nanny

Would you be willing to work with a nanny who has to bring her own child to work with YesNo

Would you be willing to work with a nanny who has to bring her own child to work with

Provisions