Full Name:

Street Address:

City:

State:

Zip: *

Email:

Cell Phone: *

Social Security Number:

Are you legal to work in the United States?

Have you ever been arrested or convicted of a crime?

Driver's License Number:

Country of Birth:

Date of Birth:

Emergency Contact Number

Relationship to Emergency Contact

Area of Miami you reside *

Job Description: *

Job Type

List Work Schedule Days/Hours

Hours

Is your schedule open and flexible?

Do you speak English?

Do you speak Spanish?

Do you smoke?

What is your salary requirement per hour for a new job?

Do you drive?

Do you own a car?

Model/Make of your car:

Year of your car:

Would you be willing to transport the children in your vehicle?

Would you be willing to use the employer's vehicle?

Do you have any driving tickets in the last 3 year?

If yes, please explain...

Do you receive text messages on your phone?

What did you do in your country?

Do you swim?

Will you clean the family's clothes?

Do you iron?

Would you be willing to cook for parents?

Would you be willing to cook for kids?

Do you observe dietary laws?

If yes, which dietary laws?

Do you like animals?

Are you allergic to animals?

Will you take care of the kids at night?

Are you willing to clean bathrooms?

Are you willing to clean up after the children?

Are you willing to wear a unifom?

Do you have newborn experience?

Will you follow a schedule?

Did you take courses in newborn care?

Experience with twins?

Experience with triplets?

If you are a live in candidate, will you share a bathroom with a child?

Are you CPR certified?

If certified, when does it expire?

If not certified, would you be willing to take CPR classes?

Are you willing to change diapers?

Are you willing to travel with the family?

Are you willing to travel with the family - by car?

Are you willing to travel with the family - by plane?

Did you attend college?

If yes, how many years did you attend?

If yes, what specialty courses?

Reference 1: Name of Employer

Reference 1: Phone Number of Employer

Reference 1: What month and year did you start?

Reference 1: What month and year did you end?

Reference 1: How old were the children when you started the job?

Reference 1: What did you do for the family?

Reference 1: Reason for leaving the job?

Reference 1: What was your salary per hour when you started the job?

Reference 2: Name of Employer

Reference 2: Phone Number of Employer

Reference 2: What month and year did you start?

Reference 2: What month and year did you end?

Reference 2: How old were the children when you started the job?

Reference 2: What did you do for the family?

Reference 2: Reason for leaving the job?

Reference 2: What was your salary per hour when you started the job?

Reference 3: Name of Emplyoer

Reference 3: Phone Number of Emplyoer

Reference 3: What month and year did you start?

Reference 3: What month and year did you end?

Reference 3: How old were the children when you started the job?

Reference 3: What did you do for the family?

Reference 3: Reason for leaving the job?

Reference 3: What was your salary per hour when you started the job?

When can you start working a new job for a family?

How did you hear about Class Act Nannies, LLC?

*******Hit Submit Now - The last questions are for office use only.

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