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Employment Application Form

Home/Candidate Resources/Employment Application Form
Employment Application FormNAHUSAadmin2019-10-14T15:38:03-07:00

Step 1 of 5 - Applicant Information

20%
    Choose any that apply - more than one choice can be made
  • Day of the WeekStart TimeEnd Time 
  • Please mark the following questions YES or NO

  • SchoolCity, StateField of StudyGraduated?Diploma Received 
  • Professional Domestic Experience

    Starting with the most recent, list the names of the families that you have nannied for or any other childcare experience, i.e. daycares, church nurseries, day camps, teaching, etc. DO NOT LIST RELATIVES.
  • Experience 1

  • PositionFamily NameFamily Phone No.Number of Children (if applicable)Ages of Children at the start of employment (if applicable)Dates Employed 
  • Experience 2

  • PositionFamily NameFamily Phone No.Number of Children (if applicable)Ages of Children at the start of employment (if applicable)Dates Employed 
  • Experience 3

  • PositionFamily NameFamily Phone No.Number of Children (if applicable)Ages of Children at the start of employment (if applicable)Dates Employed 
  • Max. file size: 50 MB.
  • This authorization and consent for release of personal information acknowledges that Nannies and Housekeepers U.S.A. (hereinafter referred to as “company” and or its agent) may conduct investigations. These investigations might include but are not limited to searches or financial or credit agencies, records of previous employment including detailed information on files in local, state, or federal agencies, worker compensation records, and motor vehicle/drivers license records.

    I understand that these searches will be used to determine employment eligibility under the company’s employment policies. Therefore, I authorize and consent to full release of records (either orally or in writing) to the authorized representative of the company. In addition, I release and discharge the company and its agents and associates to the full extent permitted by law from any claim, 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 will apply to any future update reports that may be requested and is valid for up to one year from the below date for hiring purposes. After reading this document, I understand fully its complete content and I authorize the background verification.

    I hereby attest that all of the above and previous pages of this application are true. Also, by signing this application I promise to allow Nannies and Housekeepers U.S.A. to act as my exclusive employment agency on all the interviews that I am sent to. I will not contact or directly accept employment from any family that I am introduced to by Nannies and Housekeepers U.S.A. I give permission for Nannies and Housekeepers U.S.A. to contact my references and also do a background check before I start work. I hereby give Nannies and Housekeepers U.S.A. permission to share my information with potential families that may be interested in retaining me for employment.

    Agency hereby disclaims and Applicant holds agency harmless for any liability due to the intentional or negligent acts or omissions of any family hiring the applicant. Applicant shall hold Agency and its owners, officers, employees, and agents harmless from any and all liabilities, losses, damages, payments, costs, or expenses of any kind whatsoever, which may be imposed on, incurred by, or asserted against Agency or such parties as the result of the search services provided by agency herein. Applicant represents and warrants it personally accepted each position prior to starting in the home. Applicant holds harmless obligation pursuant to this section shall survive the expiration of termination of this agreement.

  • By submitting, e-mailing, delivering this application to Nannies & Housekeepers U.S.A. you are agreeing to all terms outlined in the application

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