Employment Application

Please complete the following application form in its entirety. All of the information you provide will be held in the strictest confidence and never shared with outside businesses, government entities or individuals for any reason other than required background checks. Background checks and calls to the references you provide will only be made with your consent.

     
PERSONAL INFORMATION
     
First name
 Middle Name
Last Name
 
Address 1
     
Address 2
     
City
 State
Zip Code
    
     
Home Phone
Cellphone
   
     
Email
     
Maiden name
     
Other names used
     
How long have you lived at this address?
     
What is the highest level of schooling you have completed?
List any professional certificates
What schools have you attended?
High School
  Community College/Professional School
 
University
   Major field of study
  
     
PLACEMENT PREFERENCES
 
Please select all types of assignments you are willing to consider
On-call, in-home childcare
On-call, hotel/conference childcare
Half-day, assigned in-home nanny
Full-time, assigned in-home nanny
Summer and school vacations, assigned in-home nanny
Family travel childcare outside San Diego County
 
Are you willing to
Do light housework such as dusting, straightening-up and laundry?
Drive children to local activities in the family car?
Drive children to local activities in your car compensated for mileage?
Run local errands?
 
Are you able to make a minimum one-year commitment (Permanent Placement) Yes No
Are you able to make a minimum six-month commitment (Temporary Placement) Yes No
 
PERSONAL PROFILE
 
Why are you interested in being a nanny?
What are a few creative ways you might share your language & culture with children?
How would you describe your personality?


What do you think is the most effective way to discipline a child


What age(s) of children do you prefer to work with?
What is your native language?
What additional languages do you speak
Fluent Proficient Basic Communication
Fluent Proficient Basic Communication
Fluent Proficient Basic Communication
Do you have the legal right to work in the US? Yes No

Do you have a valid CA driver’s license? Yes No

Do you own a reliable, insured vehicle? Yes No

Do you smoke? Yes No Do you like dogs? Yes No Do you like cats? Yes No
     
Have you ever been convicted of a misdemeanor or felony? Yes No
If yes, please explain briefly
What are you long-term career goals?
What are your principal hobbies and interests?
Tell us about any of your musical or athletic talents?
What countries have you lived in or traveled to?

Is there anything else you’d like potential families to know about you?
 
PROFESSIONAL PROFILE
 
Please check all areas in which you have experience
Infant Care             
Care for children 3-6  
Care for children 7-12  
Care for children 13-16
A.D.D.                 
Mental handicaps             
Physical handicaps             
Toilet training
Can you swim?
Do you enjoy cooking?

Others:
       
Please check all areas in which you have a certification/ credential
First Aid
CPR
Infant CPR
Lifeguard
Teaching Credentials

Others:
       
Are you willing to do light housekeeping tasks such as dusting, straightening up, dishes and laundry? Yes No
Comments
 
EMPLOYMENT HISTORY
Feel free to include work experience of any kind. Because Ambassador Nannies specializes in matching families with nannies who bring with them broad international perspectives and knowledge, varied experience and interests are a plus. If you would like to include information about additional work history, please submit a resume that we can add to your personnel file.
 
Employer #1
 
Employer Name
City
  State
  Telephone
  
Employed From
  To
  Last Position Held
  
 
May we contact this employer? Yes No

Responsibilities (if childcare, please include ages of children)
Reason(s) for leaving
 
Employer #2
 
Employer Name
City
 State
Telephone
  
Employed From
 To
Last Position Held
 
 
May we contact this employer? Yes No

Responsibilities (if childcare, please include ages of children)
Reason(s) for leaving
 
Employer #3
 
Employer Name
City
State
 Telephone
  
Employed From
 To
Last Position Held
  
 
May we contact this employer? Yes No

Responsibilities (if childcare, please include ages of children)
Reason(s) for leaving
 
PERSONAL & PROFESSIONAL REFERENCES
 
Please furnish the names and contact information for three people who can provide supportive references. We encourage you to provide one personal reference and two professional references, if available. Additional references and letters of recommendation are very helpful in securing quality, long-term placements and are welcome under separate cover.
 
REFERENCE 1
Name
 Relationship
    
       
Telephone
 Email
    
 
Comments (if professional, please include employer’s title and your position)
   
 
REFERENCE 2
Name
Relationship
   
       
Telephone
 Email
   
 
Comments (if professional, please include employer’s title and your position)
 
 
REFERENCE 3
Name
 Relationship
    
       
Telephone
 Email
    
 
Comments (if professional, please include employer’s title and your position)
 
I certify that all the information disclosed on the Ambassador Nannies application is true, accurate and complete. I understand that withholding or providing false information is grounds for rejection of my application, or if employed by Ambassador Nannies, for immediate dismissal. I authorize investigation, including criminal background checks, DMV record checks and verification of legal status in the U.S., of all information contained in this application and any supplemental materials I have provided to Ambassador Nannies. I authorize any employer, person, corporation or educational institution listed in this employment application or supplemental materials to answer any and all questions and agree to hold all persons harmless for providing any and all information based on their knowledge or records.
 
Electronic Signature: By selecting SUBMIT, you hereby verify that the above information is accurate. If you cannot certify the accuracy of this entire application, select CANCEL.

 

 
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