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All information provided by the applicant may be used for TRIO and potential families. It is important you print a copy of the application for your records. Once the personal interview has been scheduled you may bring your application with you to the interview.

Keep in mind the qualifications before completing this application: You must be 20 years of age, drive your own car and show proof of car insurance. Provide at least 3 work and 2 personal references and have completed High School/GED. Must have at least one year experience working with children (not related to you) and be willing to certify or recertify in Infant/Child CPR and First Aid within 45 days of day of hire.

**The nanny is responsible for signing up for CPR and Fist Aid. TRIO covers all expenses for this course.

**We do not accept applications from candidates who wish to bring their child with them to a job.

**TRIO does not participate in nanny sharing.

**Candidates must be open to caring for children whose mother and father might work part- or full-time from their home. Keeping daily logs are mandatory for good communication between you and the family.

***Most of all, potential nanny candidates must have a true love for children and caring for them. If you have any questions regarding this information while completing this application, please call TRIO at 919.828.4212.

First name:*   Middle Initial:
Last name:*
Maiden name:
Address:*
Address:
City:*
State:*   Zip:*
County:*
Telephone number:*
Mobile number:
Best time to call:*
Email address:
Birthday:
Driver's License Number:*     State Issued:*
Social Security Number:
Previous Address 1:*
Previous Address (line 2):
Previous City:*
Previous County:*
Previous State:*   Previous Zip:*
How long did
you reside there?*
Have you ever signed up TRIO in the past?*
Position Applying For:*
Can start work:* (mm/dd/yyyy)
Work Period to End:* (mm/dd/yyyy)
Marital Status:*
Number of children
in your family:*
Religious affliation:
I prefer to work in the following areas:*
(Check all that apply)
Do you own your
own car?:* 		  What is the make and model?
   
Can you show proof of insurance?  If yes, insurance company name:
TRIO has my permission to do a background check:*
Would you work in a house with pets?*
Do you have allegies?*
Do you have health insurance?
If no, do you need health insurance to be provided by your potential employer?
Are you able to lift 30
or more pounds?*
Have you had major surgery in the past 5 years?
If requested by TRIO, can you supply a doctor's note stating you have no health problems that would limit you to care for children?*
Can you swim?*
Do you enjoy being out
in the sun?*
In case of an emergency
please call*:
Telephone number*:
How many children would you like to care for*:
Experience with age groups*:
Duties you are capable of assisting in
(check all that apply, hold down the Control key to select multiple)*:
Do you want the family to provide lunch and dinner
while on duty?*
Education:  
Name of high school*:    Graduation year*:
City and state*:
Did you graduate or
get your GED?*
Name of college:   Graduation year:
City and state:
Major:
Minor:
Are you attending
college now?
Name of Graduate School?   Graduation year:
City and state:
Currently attending?
Do you have plans to continue your education?
(Check all that apply, hold down the Control key to select multiple)*
Professional Experience:
(Most recent first please)		  
Reference One Name*:
Company name:
Best time to call:*
Telephone number*:
Job title:
Date of hire*: (mm/dd/yyyy)
Last day of employment*: (mm/dd/yyyy)
Duties*:
Salary when hired*:
Reason for leaving*:
May we call this employer*?
Reference Two Name*:
Company name:
Best time to call:*
Telephone number*:
Job title:
Date of hire*: (mm/dd/yyyy)
Last day of employment*: (mm/dd/yyyy)
Duties*:
Salary when hired*:
Reason for leaving*:
May we call this employer*?
Reference Three Name*:
Company name:
Best time to call*:
Telephone number*:
Job title:
Date of hire*: (mm/dd/yyyy)
Last day of employment*: (mm/dd/yyyy)
Duties*:
Salary when hired*:
Reason for leaving*:
May we call this employer*?
Personal Reference
One Name*:
Relationship*:
How long have you known this person?*
Phone number:*
Best time to call?*
If you babysat, was this a paying position?
Duties:
Personal Reference
Two Name*:
Relationship*:
How long have you known this person?*
Phone number:*
Best time to call?*
If you babysat, was this a paying position?
Duties:
Essay Questions:  
Why do you want to be a nanny?*
What do you feel is the MOST important responsibility when taking care of a child?*
Why do you think children like you?*
What is your philosophy of discipline and why? Give an example of using your discipline techniques*
Is there any more information you would like TRIO to know?
Have you ever worked with children who have special needs?*
Do you speak any
foreign languages?* 		 If yes, please list:
Do you drink alcohol?*   If yes, amount and frequency:
Do you smoke?*   If yes, amount and frequency:
If yes, do you have to smoke while working?
How did you hear about TRIO?*