Staff Application

Please complete the application below. Applicants residing in Florida will typically be interviewed in person. Non-Florida applicants and Florida applicants who live beyond a certain radius must be available for an electronic interview. This will be conducted on Skype, Google Hangouts or Facebook Messenger (depending on what the applicant prefers.)

Personal Information

Full Name:

Date of Birth (mm/dd/yyyy):

Street Address:

City:

State:

Zip Code:

Phone Number:

Email:

Availability

Type of Position Desired:
FT NannyPT Nanny (less than 26 hours)On-Call

Are You Currently Employed?
YesNo

If Yes, Please List Your Current Employer:

If Yes, Please List Your Current Employer's Address:

If Yes, Please List Your Current Employer's Phone Number:

Education

High School:

College and Degree Awarded:

Trade, Business, or Correspondence School:

Do You Speak any Foreign Languages? If so, Please List Them Below:

Can You Swim?
YesNo

Are You Comfortable with Pets?
YesNo

Former Employers (Most Recent First)

Employer 1:

Employer's Address:

Employer's Phone Number:

May We Contact This Employer?
YesNo

Employer 2:

Employer's Address:

Employer's Phone Number:

May We Contact This Employer?
YesNo

Employer 3:

Employer's Address:

Employer's Phone Number:

May We Contact This Employer?
YesNo

Emergency Contact

Emergency Contact's Name:

Relation:

Emergency Contact's Phone Number:

Professional / Childcare References

Reference 1 Name:

Relation:

Reference 1 Phone Number:

Reference 2 Name:

Relation:

Reference 2 Phone Number:

Reference 3 Name:

Relation:

Reference 3 Phone Number:

Personal Statement

Please Write a Brief Personal Statement to Help The Super Sitters and Families Learn More About You and Why You Should be Considered for This Position.

Please Describe How You Would Handle the Following Hypothetical Situations

A group of children are fighting over sharing a toy

What kind of indoor activities would you use to occupy a child?

An insubordinate child

Criminal History

Have You Ever Been Convicted of a Crime?
YesNo

If Yes, Please List the Crime and Sentencing:

Authorization

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information.
Certify

Electronic Signature

This is Your Legal Signature and Confirms That You Have Read and Agree to the Above Authorization:

Date (mm/dd/yyyy):

Please make sure that you receive a successful submission message below, upon submitting your application. Otherwise, there may be an error within your application and it has not been sent.