Know a parent
in need of a break? Show you care
with a CHERUB Nannies Gift Certificate
Welcome to the CHERUB Nannies
On-Line Nanny Request Form
Thank you for choosing CHERUB Nannies.
You are about to complete the CHERUB Nannies online request form.
Please answer all questions as they apply, remembering to read
all of this form before submitting your request. Applicable fees apply.
ATTENTION:
If you experience
difficulty with this online form, click
here
or call CHERUB Nannies at 703-214-4587 regarding your request
for nanny or other child care services.
Requestor's Name
Are you the parent/guardian?
Yes
No
City child care is needed.
State
Zip
Type of child care needed. Please choose one.
If other, please explain
*P/T is at least 20 hrs/week.
Home Telephone.
Work Telephone.
E-mail address.
Child's age.
If your child is of toddler age, is he/she potty trained?
Yes
No
Start Date/Specific Days Required
Will you need someone who drives?
Will a vehicle be provided?
Is your child a special needs child? (Medical/Diet, etc.)
Yes
No
If yes, please explain.
Please explain the nature of your child care request.
(i.e. Beginning (am) and ending (pm) times, etc.)
Will other nanny duties be required?
(i.e. Cooking/Lite Housekeeping, etc.)
If you are requesting a live-in nanny will nanny quarters be provided?
If yes, please describe nanny living quarters.
Are you planning to pay taxes, and medical insurance for your nanny?
Yes
No
If hiring a full-time nanny, will you pay your nanny's vacation?
Yes
No
Will you provide holiday pay?
Yes
No
In chosing a provider, is ethnicity a concern?
Yes
No
Does not matter
If ethnicity is a concern, please indicate your preference. And why.
