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**WE ARE NOT CONDUCTING SUMMER NANNY PLACEMENTS**

Please note, Beacon Hill Nannies only places FULL TIME nannies. We place LIVE IN nannies nationally; and LIVE IN or LIVE OUT nannies in the Boston area.

Please fill out the form below. It will be e-mailed directly to us and we will call you right away to complete the application process. Or, if you wish, please download or print our nanny application in PDF format (if you don't have Adobe Acrobat Reader, please click this link) or Microsoft Word and then either mail or fax the completed signed application.
Beacon Hill Nannies, Inc.
825 Beacon St, Suite 19
Newton, MA 02459
Phone 617-630-1577
Fax 617-630-9398


PERSONAL INFORMATION
Live In Live Out
Name:
First Middle Last Maiden
Address:
Street/Apt. # City/Town State Zip
Contact:
Day # Evening # Cell # Email Address
Date of Birth:(mm/dd/yyyy)
Are you legally able to work in the USA? YES NO
Do you have a valid driver’s license? YES NO
License #: State Issued:
Do you have a current passport? YES NO
Do you have a car? YES NO What make/model/year?
Are you willing to transport children in your car? YES NO
Please list any foreign languages spoken and your level of fluency:
Are you certified in CPR? YES NO First Aid? YES NO
(If so, you will need to furnish copies of your cards to BHN.)
Date Available
**We are not conducting summer nanny placements**
Geographic Preferences
Desired Weekly Salary (before taxes)
Do you need health insurance? YES NO
Please tell us how you heard about Beacon Hill Nannies.

EDUCATION

High School Name College 1 Name
City/State City/State
Yrs Attended Date Grad Yrs Attended Date Grad
Degree/Major Degree/Major
Did you receive a degree?YES NO Did you receive a degree? YES NO
College 2 Name Graduate School Name
City/State City/State
Yrs Attended Date Grad Yrs Attended Date Grad
Degree/Major Degree/Major
Did you receive a degree?YES NO Did you receive a degree? YES NO

CHILDCARE EXPERIENCE
(Please list ALL childcare experiences including volunteer, internships, student teaching, long-term babysitting, etc. since you graduated High School)

Name of Family/Company City/State/Zip Dates Employed (mo/yr – mo/yr)
Position Ages of children when you began  
 
Contact/Phone
  Cell Work Home
May we contact them at this time? YES NO
Reason for leaving?



Name of Family/Company City/State/Zip Dates Employed (mo/yr – mo/yr)
Position Ages of children when you began  
 
Contact/Phone
  Cell Work Home
May we contact them at this time? YES NO
Reason for leaving?



Name of Family/Company City/State/Zip Dates Employed (mo/yr – mo/yr)
Position Ages of children when you began  
 
Contact/Phone
  Cell Work Home
May we contact them at this time? YES NO
Reason for leaving?



Name of Family/Company City/State/Zip Dates Employed (mo/yr – mo/yr)
Position Ages of children when you began  
 
Contact/Phone
  Cell Work Home
May we contact them at this time? YES NO
Reason for leaving?



Please list any additional childcare experiences below:

PLEASE CHECK IF YOU HAVE EXPERIENCE IN THE FOLLOWING AREAS:
Cared for a newborn (under 3mths) Toilet trained a child
Cared for infants (3 – 12mths) Cared for school aged children Cared for multiples
Helped a child cope with divorce
Cared for a child with special needs Bathed a baby/child
Cared for a nursing baby Cared for ill children
Given medications to children Safety-proofed a home
Helped a child cope with death Cared for toddler/preschool aged (12 – 24mths)

SHORT ESSAY QUESTIONS

1. What qualities should a successful nanny possess?

2. If you’ve never been a nanny before, please explain why you wish to pursue this opportunity.

3. If happy in the position, what would be the maximum time you would consider staying with a family?

4. Are you willing to travel with a family?

5. What are your future goals?

6. What kind of hobbies, interests, and organizations do you pursue? What do you enjoy doing in your spare time?

7. Please list activities you enjoy doing with children.

8. What is your current health status? Are you currently taking any prescribed medications? Do you have any allergies?

9. Have you ever been convicted of a crime? Please explain.

10. Please describe your driving record. Include tickets, accidents, suspensions, and violations and dates received.

11. Do you smoke?

12. Can you swim? If so, how well do you swim?

13. Do you drink? If so, how often do you drink?

14. Have you lived away from your family before? If so, how far away from home did you live, and for how long?

15. Please explain your philosophy of discipline and what consequences you use in disciplining children.

16. Please tell us about your best and worst childcare experiences.

17. How would your friends and family describe your personality?

In the space below, write at least a 500 word essay to introduce yourself to parents. Please briefly describe your family background, focusing on the positive aspects, and what brought you into the childcare field. Discuss, in detail, what qualities you have to offer a family as their nanny while referring to some of your previous positions that you have had with children.

ADDITIONAL NON-CHILDCARE WORK HISTORY

Employer City/State Dates Employed (mo/yr – mo/yr)
Position Supervisor’s Name  
 

Contact/Phone Alternate Phone Number
May we contact them at this time? YES NO
Reason for leaving?


Employer City/State Dates Employed (mo/yr – mo/yr)
Position Supervisor’s Name  
 

Contact/Phone Alternate Phone Number
May we contact them at this time? YES NO
Reason for leaving?


Employer City/State Dates Employed (mo/yr – mo/yr)
Position Supervisor’s Name  
 

Contact/Phone Alternate Phone Number
May we contact them at this time? YES NO
Reason for leaving?


Please list any additional NON childcare work experiences below:


CHARACTER REFERENCES
Non-childcare or work related (e.g. Clergy, professors, and leaders of the community). Please do not include relatives or friends.

Name Name
Home Phone Home Phone
Cell Phone Cell Phone
Work Phone Work Phone
Relationship Relationship

I hereby attest that all of the above information is true and accurate. I have given full disclosure of my entire work history to Beacon Hill Nannies, Inc. I further agree that I will not accept employment from any Beacon Hill Nannies’ client or referral of a Beacon Hill Nannies’ client without the express permission of Beacon Hill Nannies, Inc.

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