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Name/Name of Spouse:
Number of children/ages/boy/girl:
Any special characteristics/health issues we need to know about?
Start date-Approx. end date:
Do you need a nanny who drives? Yes/No/Open to Either:
Days nanny will work:
If live-in do you have a room for the nanny: Please specify w/bathroom/in-law suite?
How many rooms in the home?
Description of an ideal nanny:
Have you had a nanny before? Reason for leaving?
Languages spoken/Regional background:
Cooking required: If yes, please specify veg/non-veg/type of cuisine
Payment method: W-2/Check/Cash
How often paid: Weekly/Bi-weekly
How did you hear about us: