angelcarenannyagency.ca

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Bio Data

Nannies please complete this application, you will need to send us a picture of you by email or mail or a colour fax machine.

Position Desired *		Please put in what position you're applying for

Date		Please enter the date here

Name *		Please enter your full name in the following order Last Name, First Name, Middle names

City Address *

Telephone for your City Address *

Provincial Address		Please enter your Provincial address and phone # in this box

Email Address

Date of Birth *

Place of Birth		Please enter your place of birth here

Height *

Weight *

Religion		Please enter your religion here

Sex *	Male Female	Please check one of the boxes

Name of Spouse

Spouse's Occupation

Spouse's Address

Spouse's Phone #

Father's Name *

Father's Occupation

Father's Address

Father's Phone #

Mother's Name *

Mother's Occupation

Mother's Address		If same as Father's please put (SAME)

Mother's Phone's #		If same as Father's please put (SAME)

Language or Dialect Spoken & Written

EDUCATION		PLEASE ENTER YOUR EDUCATIONAL ATTAINMENT INFO BELOW

Elementary School Info		Please put your Elementary school info in this box. School name, address and year attended.

High School Info *		Please put your High school info in this box. School name, address degree/certificate received and year attended.

Vacational Info		Please put your Vacational school info in this box. School name, address, degree/certificate received and year attended.

College Info		Please put your College info in this box. College name, address, courses taken, degree/certificate received and year attended.

Special Skills		Please put any special skills you have in this box

EMPLOYMENT		PLEASE ENTER YOUR EMPLOYMENT RECORDS INFO BELOW

Name of Employer *		Please put the name of employer, address, position and date (date started and date ended)

Name of Employer		Please put the name of employer #2, address, position and date (date started and date ended)

Name of Employer		Please put the name of employer #3, address, position and date (date started and date ended)

GENERAL INFORMATION

Why do you want to be a caregiver?

Have you worked as a caregiver or nanny before? *	Yes No

Will you work with children? *	Yes No

Will you work with the elderly? *	Yes No

Will you work with those with disabilities? *	Yes No

Have you worked with newborns? *	Yes No

What experience do you have in taking care of newborns(0 to 3 months)? Give details

Have you worked with children before? *	Yes No

What experience do you have in taking care of toddlers(1 year and older)? Give details.

How would you handle a temper tantrum?		Temper tantrums are disruptive or undesirable behaviors or emotional outbursts displayed in response to unmet needs or desires. They may also refer to an inability to control emotions due to frustration or difficulty expressing a particular need or desire

How would you handle a sick child? *

How would you handle a medical emergency?

Have you worked with an elderly person before? *	Yes No

What activities will you do to enhance children's cognitive development?

How do you discipline children?

If you have worked with an elderly person before, describe your experience. Give details.

Are you willing to work flexible hours? *	Yes No

Can you swim? *	Yes No

Can you cook? *	Yes No

Do you smoke? *	Yes No

Can you do simple sewing? *	Yes No

Will you work where there are pets? *	Yes No

What do you like to do in your free time?

REFERENCES		PLEASE ENTER YOUR REFERENCES BELOW

Reference #1		Please put the name of your reference, address, phone # and any extra info in this box

Reference #2		Please put the name of your reference, address, phone # and any extra info in this box

Reference #3		Please put the name of your reference, address, phone # and any extra info in this box

I hereby certify that the above information is true and correct to the best of my knowledge and belief *		Please put your name and today's date to certify that all the above info is true.