EmailMe Form - Santa Fe Nannies - Parent Registration Form

Santa Fe Nannies - Parent Registration Form
Welcome to our online Parent Registration!

BEFORE YOU BEGIN:
1. All fields with asterisks are required.
2. You will be taken to a confirmation page once your registration form has been sent successfully.
3. We encourage you to call us to confirm we have received it.
4. Thank you for your interest in Santa Fe Nannies, we look forward to working with you!

Parent/Guardian

Name

First

Last

Home Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Email

Cell Number

###

####

Work Number

###

####

Occupation, Company and Work Address

Parent/Guardian

Name

First

Last

Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Email

Cell Number

###

####

Work Number

###

####

Occupation, Company and Work Address

Children's Informaion

1. Name

First

Last

Age

Birthdate

Child's Gender

Please Describe any special needs your child may require.

2. Name

First

Last

Age

Birthdate

Child's Gender

Please Describe any special needs your child may require.

3. Name

First

Last

Age

Birthdate

Child's Gender

Please Describe any special needs your child may require.

4. Name

First

Last

Age

Birthdate

Child's Gender

Please Describe any special needs your child may require.

5. Name

First

Last

Age

Birthdate

Child's Gender

Please Describe any special needs your child may require.

Indicate the type of caregiver needed: *

Babysitter

Nanny

Home Manager

After-school Nanny

Mother's Helper/ Personal Assistant

Date-night Nanny

House Keeper

Manny (Male Nanny)

Days Nanny is Needed *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Hours: *

Duties in addition to childcare *

Laundry

Dishes

Tutoring

Vacuuming

Dusting

Run Errands

Transporting Children

Clean Bathrooms

None

What adults are home during the day? Do you have a home office?

Do you have any pets? Describe.

Is there any travel required? How often?

Describe the skill sets, personal qualities, and educational level you are seeking:

Start Date *

End Date

Salary Range *

Will taxes be deducted from this salary?

Yes

Duration of Job *

One Year or More

6-12 months

3-6 months

3 months or less

Babysitting only

Is Driving Required? If so, Is gas reimbursed or is a car provided?

What benefits are provided? *

Paid Vacation

Paid Holidays

Bonus

Use of Car

Cell Phone

Health Insurance

Country Club Membership

None

How did you find Santa Fe Nannies? *

$25 Dollars of each nanny placement goes to charity. You get to choose!

Casa De Amor Para Ninos - Mexico Orphanage

CareNet - Crisis Pregnancy Center

Santa Fe Homeless Ministry

100 Club - Supporting those behind the badge.

I agree not to begin employment to any nanny referred to me by Santa Fe Nannies until the placement fee has been paid in full. I further agree not to offer any position to any nanny represented by Santa Fe Nannies via a second party or by other means with the intent to avoid paying all required placement fees.
I agree not to accept any friend or family member referred to me by a nanny currently represented by Santa Fe Nannies.

Do you agree with the terms and conditions? *

Yes, I agree.

Initial *

Date *

YYYY

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