Full Name *

Email *

Phone *

Date Available *

Date of Birth *

SSN# *

Drivers License # and State of Issue *

Do You Own a Car? *

Yes No

Cass & Company Performs Background Checks on Candidates, Are You OK With This? *

Yes No

Cass & Company Can Only Place Those Legally Authorized to Work in the United States. Do You Have Legal Authorization to Work in the USA? *

Yes No

Place of Birth? (City, State): *

Are You Registered With Any Other Nanny Agency at This Time? *

Yes No

Are You CPR or First Aid Certified? *

Yes No

Are You Comfortable Working in a Home With Animals? *

Yes No

Do You Swim? *

Yes No

Could You Pull a Child Out of a Pool Who Fell In? *

Yes No

Please Check What You Are Willing to do From the List Below: *

Work on Holidays if Needed Work for a Parent Who Works From Home Run Errands and Grocery Shop Work Evenings and Weekends

Please answer the following questions if you are applying for a position where you might work in a home with children/ Even if you are not the primary caregiver. Please use a separate piece of paper if additional space is needed. If Applicable: What Age Groups of Children Do You Have Experience With? *

Explain Where and When: *

Cass & Company Jobs are One-Year Commitments and Contracts are Required to be Signed. Is This OK With You?: *

Yes No

Do You Have Any Special Medical Considerations or Physical Limitations?: *

Yes No

If Yes, Please Explain:

Do You Have Any Body Art or Pierced Places on Your Body?: *

Yes No

Are There Are Any Childcare, or Other Household, Corporate or Related Experiences That You Are Not Including That You Have Worked or Volunteered For? *

Yes No

If There Are Any Childcare-Related, Household, Corporate Experiences You Are Omitting, Please Explain Your Reasons for This: *

Cover Letter - Include Your Personality and Strengths: *

Upload CV/Resume *Allowed Type(s): .pdf, .doc, .docx

I agree not to refer to any client/Applicant (seeking a job) that I am referred to (Via Cass & Company LLC) or give information about, to any agency or person regarding a position Cass Company LLC tells me about. I understand that a fee will be due to Cass & Company LLC of the full placement fee for the client I have been given information about if I transfer/give information regarding Cass Company's property to other person(s)I and it will be my responsibility to pay fee for placement ( regardless if there is a hire ) that to: Cass & Company should I pass on a Name or information about a client/ candidate to others at that time (fees range from *$1250. to $15,000. or more [at this time}. I further understand that all clients' /candidates information is totally confidential and the property of Cass & Company LLC only, a Boston Company. *

Check to Agree with Terms and Conditions

Enter/Type Signature *

Privacy Policy: Information collected by Cass & Company, LLC will be used only for the purpose of fulfilling our services which you have requested. Information that you provide to Cass & Company, LLC will not be given to any other parties without your written consent. *

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