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JESS' WAY POP N' PLAY
Sign In
My Account
Welcome
About
Pricing
Contact
Store
JESS' WAY POP N' PLAY
Baby Got Backup!
Jess’ Way Nanny Application
Name
*
First Name
Last Name
Preferred Pronoun
She/Her/Hers
He/Him/His
They/Their/Them
Other
Birthday
MM
DD
YYYY
Email Address
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone Number
*
(###)
###
####
May we reach out to you via text message?
Yes
No
Call only
Preferred Contact Method
*
Cell Phone
Home Phone
Email
How did you hear about Jess' Way Nanny Agency?
*
Friend
Emerald Doulas
Google search
Flyer
Facebook
Instagram
Other
What position are you are applying for?
*
Full-time Nanny
Part-time Nanny
Temporary Nanny
Summer Nanny
Backup Babysitter
Jess' Way Transportation Driver
COVID-Coverage Nanny
When Can You Start?
*
MM
DD
YYYY
Do you need to relocate for the position you're interested in?
Yes
No
What area are you willing to work?
*
Durham
Raleigh
Chapel-Hill
Hillsborough
Burlington
Mebane
Anywhere
Do you have reliable transportation?
*
Yes
No
Would you work in a house with pets?
*
Yes
No
Dogs only
Cats only
Do you have any allergies?
If yes, please list allergies below.
Do you have health insurance?
*
Yes
No
Are you able to lift up to 30 pounds?
*
Yes
No
Have you had major surgery in the past 5 years?
If so, please describe here.
If requested by Jess's Way, can you supply a doctor's note stating you have no health problems that would limit you to care for children?
*
Yes
No
Can you swim?
*
Yes
No
Do you enjoy being outdoors and playing in the sun?
*
Yes
No
In case of an emergency please call (Name, address, phone)
*
How many children are you comfortable taking care of?
*
1
2
3
4
5+
Jess's Way screens every potential nanny do you consent to a background check?
*
Yes
No
Education
Name of High School, Address, City, State
*
High school graduation year.
*
MM
DD
YYYY
Name of College, City, State
College Major, Minor
Graduation Year of College (if applicable)
Name of Graduate School, City, State
Do you have plans to continue your eduction?
Yes
No
Professional Experience
Jess Way requires at least 3 years of professional childcare experience. Do you meet this qualification?
*
Yes
No
Current Occupation
*
Name of your current or employer.
First Name
Last Name
Phone number of your current supervisor or employer.
*
(###)
###
####
What is your job title? Please list a description of duties.
*
What was your reason for leaving your previous job?
*
1. Please list a professional reference below (Name, Title, Address, Phone & Email)
*
2. Please list a professional reference below (Name, Title, Address, Phone & Email)
*
3. Please list a professional reference below (Name, Title, Address, Phone & Email)
Desired Hourly Rate
*
What is your desired Yearly Pay Range?
*
Do you have a professional resume and/or certificates ? If yes, please email to jesswaynanny@gmail.com
*
Yes
No, but I will create one.
How many years of child care experience do you have?
*
What activities have you done with the children in your care?
*
Professional Headline
*
Describe yourself in few words, for example: Experienced and Thoughtful Nanny
Professional Summary
*
Use this field to list your skills, specialities, experience or goals
Have you ever worked with children who have special needs?
*
Yes
No
If you have worked with special needs children, please tell us about your experience.
Do you speak any foreign languages? If so please list.
Is your Pediatric CPR + First Aid Certification up-to-date?
*
Yes
No
Yes, but needs renewal.
Do your current employers know you're looking for new employment?
*
Yes
No, I would prefer to give them notice first.
I would prefer to keep this confidential.
Are you vaccinated for COVID-19?
*
Yes
No
No, but willing to be vaccinated.
Are you open to receiving boosters for COVID-19, as recommended?
*
Yes
Willing to be boosted
No
Would you prefer your new employers be vaccinated for COVID-19?
*
Yes
No
Thank you!
