Nanny Placement Application — CuraHome Care Co.

Section 1 — Personal Information

First Name *

Last Name *

Date of Birth *

Age *

Street Address *

City *

State / ZIP *

Phone Number *

Email Address *

Emergency Contact Name *

Emergency Contact Phone *

Legal Right to Work in the U.S. *

Yes No Visa / Sponsorship

If Visa / Sponsorship, please explain

Section 2 — Availability & Compensation

Position Type (select all that apply) *

Days Available

Times Available

Desired Hourly Rate ($) *

Desired Weekly Hours *

Available Start Date

Preferred Contract Length

Additional Availability Questions

Are you comfortable with overnight stays? *

Yes No Depends on the situation

Maximum number of children you're comfortable caring for at once *

1 2 3 4+

Are you willing to help watch children at family parties or events? *

Yes No Maybe / open to discussing

Section 3 — Professional Experience

Years of Professional Nanny Experience *

Years of Other Childcare Experience

Ages of Children Most Experienced With

Max Number of Children Cared For at Once

Comfortable Caring For (select all that apply)

Experience with Children with Special Needs or Behavioral Challenges?

Yes No

If yes, please describe

Describe Your Professional Nanny / Childcare Experience *

Section 4 — Certifications & Skills

Languages Spoken

Social Media Handles (optional)

Section 5 — Transportation & Household

Valid Driver's License?

Yes No

Reliable Transportation?

Yes No

Comfortable With Household Tasks (select all that apply)

Comfortable with Pets?

Yes No Depends on the pet

Travel & Scheduling Flexibility

Are you willing to travel with a family? *

Yes No Domestic only Open to discussing

Do you have a valid passport? *

Yes No In progress

Are you open to working overtime hours when needed? *

Yes No Occasionally / with notice

Section 6 — Professional References (Non-Family)

Please provide three professional references, ideally from previous nanny or childcare employers.

Reference 1

Full Name *

Relationship to You *

Phone Number *

Email Address

Reference 2

Full Name *

Relationship to You *

Phone Number *

Email Address

Reference 3

Full Name

Relationship to You

Phone Number

Email Address

Section 7 — Your Nanny Philosophy

Why do you want to join the CuraHome Nanny Program? *

Describe your caregiving philosophy and approach with children. *

How do you handle a child who is having a difficult behavioral moment? *

Is there anything else you'd like us to know about you?

Section 8 — Consents & Signature

Full Legal Name (Typed Signature) *

Date *

Nanny Program Application

CuraHome Care Co.

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