
                  THE 
MC 
NANNYAGENCY 
                             If you are interested in joining our team as a 
                                                Nanny, Housekeeper, Babysitter or Personal Assistant please  
Fill                                           fill this out and return it via fax to 818-301-2502 you can call 818-232-7688 
Pl                                            Please be aware that by signing this you authorize the MC Nanny Agency 
                                                    to run a Complete background check. 
                                                     www.themcnannyagency.com 
 
 
     
     
NANNY APPLICATION 
 
First Name      
Last Name      Email      Date      
 
Address      
City      State __________ Zip       
 
Telephone _______________________ Cell______________________ Date of Birth _____________  City of Birth    
  
 
Social Security Number        
Driver’s License#:      State      
 
Do you own a car? _________ Languages spoken          
 Lang. Read?     
 
How did you find us (please check one)? _______Flyer _________ Ad __________Referral    
  Friend       
 
JOB PREFERENCES 
Live-In (circle one)    Y/N      If yes, what days can you work?                  
 
If yes, do you require that you be able to stay on the weekends?                
 
Can you do an overnight with notice?             
 
Live – Out (circle one) Y/N    
If yes, what days & hours can you work?            
 
 
What age group do you prefer to care for?            
 
 
Maximum number of children you will care for __________ Would you care for twins?            
 
 
Will you work with children that have disabilities?           
 
 
Will you do light or full housekeeping?            
 
 
Will you cook for children and or the family?           
 
 
Would you work in a house with pets? ____If no, please explain why               
 
 
Do you have any allergies?            
 
Have you ever been terminated from a position, if so why?          
 
 
Have you ever left a position if so why?           
 
What type of car do you drive?             
 
 
Do you have experience driving children around?           
 
Are you comfortable running errands?            
 
 
Do you have any administrative or computer experience?          
 
Have you ever worked in a Kosher home?            
 
  
Have you ever cooked for a Kosher family?            
 
When can you start?              
 
 
What is your desired weekly salary (before taxes)?