Thank you for your interest in becoming an Iowa Elite Nanny, and taking time to fill out our nanny employment application.

For questions or more information, contact Iowa Elite Nannies at 319-640-0332 or click here to contact us via email.

We understand our application is long. But, in order to ensure our nannies are trustworthy and qualified, we must cover areas of concern. Please be honest and keep this in mind as you fill out our application below. If you prefer a printer-friendly version to fill out click here to download one.

 

    *Indicates required field


    Are You Comfortable Transporting Children in a Vehicle? YesNo

    Do You Require a Vehicle to be Provided? YesNo

    Do You Own a Vehicle? YesNo

    If Yes, Enter Make and Model:

    Are You Open to Using Your Car for Travel With the Kids? YesNo

    Do You Have Insurance? YesNo


    Job Preferences

    Please Check Your Preferences: Live-InLive-OutFull-TimePart-TimeSummer/TemporaryWeekends

    Are You Flexible on Days and Hours? Very FlexibleSomewhat FlexibleNot Flexible

    How Long Do You Want to Work in This Position? 6 Months1 Year2 Years3+ Years

    Type of Job Applying For: SitterNannyNanny/HousekeeperNanny/Household Manager

    Please Select the Weekly Duties You Are Willing to Do: Light HousekeepingHeavy HousekeepingChildrens' LaundryGrocery ShoppingMeal PlanningCooking for Kids or FamilyDrivingNeighborhood Carpool to Activities/SchoolErrandsDoctor Appointments

    Are You Willing to Travel With the Family?* YesNo

    Do You Smoke?* YesNo

    Do You Drink Alcohol?* YesNoOccasionally


    Pets

    Is Working in a Home With Pets Okay? YesNo

    Are You Allergic to Dogs? YesNo

    Are You Allergic to Cats? YesNo

    Are You Willing To (Check All That Apply): Care For the Family PetVet AppointmentsWalks


    Education

    Did You Graduate?* YesNo


    Hobbies and Interests


    Medical and Mental Health Information

    In order to assure safe child care we must know about medical and psychiatric conditions that could affect your ability to perform the job.

    Are You Presently Suffering From Any Communicable Diseases That Could Be Transmitted to a Child You Are Caring For?* YesNo

    Are You Presently Taking Any Medications, Prescribed or Not, That Affect Your Judgement, Coordination, Levels of Alertness, and Ability to Respond in an Emergency?* YesNo

    Do You Have Any Physical Condition That Might Impair or Prevent Your Ability to Perform Any Reasonably Physical Act Normally Required in the Care or Protection of Children?* YesNo


    First Aid and CPR

    Do You Have a Current CPR Certification?* YesNo

    Do You Have a Current First Aid Certification?* YesNo

    Can You Swim?* YesNo

    Are You a Certified LifeGuard? YesNo


    Child Care

    Do You Have Experience Working For Families of Mulitiples? YesNo

    Would You Care for Twins? YesNo

    Would You Work With Children With Special Needs? YesNo

    Please Indicate the Type of Family Situation You Would Like to Work In: Parents Working Outside the HomeAt-Home Parent


    Previous Nanny Experience
    List previous employers with the most recent first.

    EMPLOYER 1

    Please Select One:* GrossNetPer HourPer Week

    Type of Position:* Live-InLive-OutFull-TimePart-Time

    Responsibilities (Check All That Apply)*: Light HousekeepingHeavy HousekeepingCookingDriving KidsErrandsHomeworkDoctor AppointmentsSwimming LessonsOther

    EMPLOYER 2

    Please Select One: GrossNetPer HourPer Week

    Type of Position: Live-InLive-OutFull-TimePart-Time

    Responsibilities (Check All That Apply): Light HousekeepingHeavy HousekeepingCookingDriving KidsErrandsHomeworkDoctor AppointmentsSwimming LessonsOther

    EMPLOYER 3

    Please Select One: GrossNetPer HourPer Week

    Type of Position: Live-InLive-OutFull-TimePart-Time

    Responsibilities (Check All That Apply): Light HousekeepingHeavy HousekeepingCookingDriving KidsErrandsHomeworkDoctor AppointmentsSwimming LessonsOther

    OTHER EMPLOYMENT


    Please Take Time to Answer How You Would Handle the Following Situations:


    Please List Three Personal References. Do Not Include Relatives.

     

     


    Emergency Contact Information


    Certification of Application: By submitting this form, I hereby certify that the information contained herein is true and correct to the best of my knowledge.*