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Please fill out below. Items marked “*” are required.
Your Name*
Your Email*
Street Address*
Apartment/Unit
City*
State*
Zip Code*
Home Phone*
Mobile Phone*
Desired Salary*
What type of position are you looking for?*
What hours are you available to work each day?*
When are you available to start work?*
Can you take on housekeeping responsibilities? yesno
How many years of experience do you have, in total?*
Are you a citizen of the United States? yesno If no, are you authorized to work in the U.S.? (Please provide copy of proof) yesno Attach proof here (2mb limit)
Have you ever been convicted of a felony? yesno If yes, when?
Are you certified in CPR and/or First Aid for infants and children? yesno
Do you drive? yesno
Any aversions/allergies to pets? yesno
Any other information you believe we should know about your background?
Address
Attended dates to
Did you graduate? yesno
Degree
Please list three (3) references, listing previous employers only and current or most recent first.
Parents Names
Phone numbers
Duration from to
Reason for Leaving?
Pleace Check Full TimePart Time
If part time, please indicate frequency
Responsibilities
Number and ages of children you cared for
AUTHORIZATION AND CONSENT FOR RELEASE OF INFORMATION This is to authorize and consent to the release of personal information and acknowledge that OutBaby (the “company”), its agents and others may conduct pre- employment investigations. These investigations might include, but are not limited to, searches of financial or credit agencies, records of previous employment including detailed information on work history, searches of educational institutions, military records, criminal history information on file in local, state or federal agencies, workers compensation records and motor vehicle/driver's license records. I understand that these searches will be used to determine my eligibility under the company’s policies for employment. Therefore, I authorize and consent to full release (either orally or in writing) of such information and search results to the company and its agents and customers. In addition, I release and discharge the company and its agents and customers to the full extent permitted by law from any claims, damages, losses, liabilities, costs, expenses or any other charge or complaint filed with any agency arising from retrieving and reporting this information. I understand that this notice is valid for up to one year from the below date for hiring purposes. After reading this document, I understand fully its complete contents and I authorize the background verification and searches. In the event that information from the report is utilized in whole or in part in making an adverse decision with regard to my potential employment, before making the adverse decision, I will be provided a copy of the consumer report and a description in writing of my rights under the Federal Fair Credit Report Act.
I acknowledge my understanding and agreement with these terms by returning this agreement to Outbaby
INTENT OF REFERRAL
OutBaby is a referral service. I understand and agree that it is my responsibility to negotiate the terms of my employment with the employing families.
If I accept employment with a family referred to me by OutBaby, I agree to:
Notify OutBaby immediately with the name of the family with whom I have accepted employment.
• Agree to begin my position only after OutBaby receives its placement fee from my employing family. In the extremely unlikely event that my performance as a Nanny does not measure up to the standards of OutBaby, then OutBaby is under no legal or contractual obligation to refer me for further employment as a Nanny. In addition, I agree to hold OutBaby harmless from any injuries I may sustain in the course of my employment and to indemnify OutBaby from any and all claims, including attorney fees and court costs, made by any person arising out of my employment as a Nanny. I understand that I am using the services of OutBaby as a referral service and I will not be considered an employee of OutBaby. I understand that I will not be charged a placement fee by OutBaby and my employer will pay the placement fee. I agree that I will not travel to the employer's home until the required placement fee has been received by OutBaby. I understand that if I accept a position with any family referred by OutBaby, I will notify OutBaby within 24 hours of acceptance. I understand that OutBaby acts solely as a facilitator and is neither responsible nor liable for any act of my employer. Submission of this application implies that all information stated is true and complete to the best of my ability. I understand that omitting information or providing false information is grounds for immediate dismissal from employment as a Nanny. I acknowledge my understanding and agreement with these terms by signing below and returning this agreement to OutBaby.
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