Family Registration Form

Please fill out and submit the form below.

First Name*

Last Name*

Address*

City*

State*

Zip Code*

Is this the job location?

yes

no

Phone #*

E-mail*

What is your profession?

Do you work from home?

First Name

Last Name

Address (if different)

City,State,Zip

Is this also the job location?

yes

no

Phone #

E-mail

What is your profession?

Do you work from home?

Child #1*

Child #2

Child #3

Child #4

Do you plan on adding any additional children in the next 12 months?

yes

no

If Yes,please explain:

Please list and give a brief description of each of your pets:

What TERM commitment are you looking for?

Full Time Permanent (>30 hours,>12 wks)

Part Time Permanent (10-30 hrs,>12 wks)

Full Time Temp (>30 hrs,2-12wks)

Part Time Temp (10-30 hrs,2-12weks)

What living situation(s) are you willing to consider?

Live-In Nanny

Nanny resides in their own home

Are you willing to hire a nanny who has their own child? Some families are considering this option for socialization purposes duing Covid-19

No

Yes, and they are welcome in our home

Yes, but only if they do not bring them along

Please write the nannies Job Description:*

When does this job start?*

Is the start date flexible?*

Is there anything you would like to convey to My Boulder Nanny that you do not want in your Job Listing?*

Please list the hours you will NEED for each of the above selected days*

Please list any additional hours or responsibilities that would be NICE to have

Please describe your absolute perfect nanny:*

From that description of your perfect nanny,what are the MUST haves,NICE to haves:

Please list any deal breakers (i.e. tattoos,personality traits,etc.):*

Are you willing to interview/hire a Male nanny (aka a Manny?):*

Please provide a current photo of your family.

Choose a file…