Candidate Application Form

To submit application, your name, e-mail, and a complete job reference are required fields.

(*) Denotes required field

 Date:
* Name:
 Street Address:
 City:
 State:
 Zip:
* E-mail:
 Home Phone:
 Cell Phone:
 Date of Birth:
 Place of Birth:
 In case of emergency, contact name:
 Relationship:
 Phone:
 Are you authorized to work in the United States?
  
 Social security #:
 Driver license #/State ID #:
 Expiration Date:
 What type of job are you applying for?
  
  
 What is your job preference?
   
   
What days/hours are you available to work?
 Monday:
 Monday Hours:
 Tuesday:
 Tuesday Hours:
 Wednesday:
 Wednesday Hours:
 Thursday:
 Thursday Hours:
 Friday:
 Friday Hours:
 Saturday:
 Saturday Hours:
 Sunday:
 Sunday Hours:
 Desired Salary:
 When can you start?
 What languages do you speak?
 Have you ever been arrested or convicted of a crime?
  
 If yes, please explain:
 Do you smoke?
  
 Did you graduate from high school?
  
 Did you attend college?
  
 If yes, how many years?
 What was your major and minor study?
 Have you had any child development courses?
  
 What did you do in your country?
 Do you drive?
  
 Do you own a car?
  
 If yes, what model/make?
 Year?
 Have you had any traffic tickets in the last 3 years?
  
 If yes, please explain:
 Would you be willing to use your vehicle for work purposes?
  
 Would you be willing to use the family’s vehicle?
  
 Do you know how to swim?
  
 Do you like animals?
  
 Would you be willing to baby-sit in the evenings?
  
 Would you be willing to cook for the kids?
  
 Would you be willing to cook for the parents?
  
 Do you observe any dietary laws/requests?
  
 If yes, please explain:
 Are you allergic to any specific foods?
  
 If yes, please explain:
 Would you be willing to wear a uniform?
  
 Would you be willing to follow a schedule?
  
 Would you be willing to clean bathrooms?
  
 Would you be willing to do the family’s laundry?
  
 Would you be willing to iron?
  
 Would you be willing to share a bathroom with the kids?
  
 Are you CPR and First Aid certified?
  
 Expiration date:
 If not, would you be willing to take a CPR class?
  
 Would you be willing travel with the family?
  
 By airplane?
  
 By car?
  
 Have you worked with Twins?
  
 Triplets?
  
 Have you worked with infants?
  
 What age children do you have experience working with?
 Have you worked with disabled children?
  
 If yes, what types of disabilities have you worked with?
 What types of activities would you do with the children?
 What are your future goals and plans?
 How long do you plan to stay with a family?
* 1. Start and end date of employment:
* 1. Name of employer:
* 1. Phone:
* 1. Responsibilities:
* 1. Ages of children when position began:
 1. Ages of children when position ended:
* 1. Reason for leaving:
 2. Start and end date of employment:
 2. Name of employer:
 2. Phone:
 2. Responsibilities:
 2. Ages of children when position began:
 2. Ages of children when position ended:
 2. Reason for leaving:
 3. Start and end date of employment:
 3. Name of employer:
 3. Phone:
 3. Responsibilities:
 Ages of children when position began:
 3. Ages of children when position ended:
 3. Reason for leaving:
 Do you have any other work references?
 Do you have any personal references?
 Is there anything else you would like a prospective employer to know about you?
 How did you learn about Class Act Nannies, LLC?

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