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I am looking for:

Located:

Gender:

DID YOU KNOW?

nanny/caregiver

children

nannies/caregivers

children

DID YOU KNOW?

A nanny/caregiver cares for your child in your home.

A nanny/caregiver covers your child’s basic needs while you are away—supervising, protecting, feeding, and bathing.
A top-notch nanny/caregiver will also calm your child when frightened, comfort your child when hurt, encourage growth and learning, and provide a little TLC whenever needed.

EMPLOYER APPLICATION FORM

Employer Contact Information

Full Name:

Street Address:

City/Province

Postal Code

Home Phone:

Cell Phone:

Fax #:

E-mail:

Best time to call:

Morning
After Noon
Evening

Nanny / Caregiver Specific Information

What type of Caregiver & Position are you seeking?

(Example) - Nanny, Full-time Live-IN

Nanny
Eldercare
Full-time, Live-In
Full-time, Live-out

When would you like the caregiver to start?

As soon as possible
2 months or more

Do you require a caregiver with a license?(only available with local caregivers):

Yes No

Our nannies & caregivers work 5 days a week (Monday-Friday). If you need additional
days, or have unusual schedule or would like the nanny or caregiver to perform additional
tasks, please describe...

Approximate proposed hours per week for the nanny/caregiver:

Do you have any pets? If so, please circle,Specify for other:

Dog(s)
Cat(s)
Other

How many children do you have?

What is/are the age,(s) birth dates & gender(s) of the individual(s) requiring care?

Nanny/Caregiver Duties

Expectations Of a Nanny/Caregiver

Does the individual(s) in need of care have special needs? YES / NO (if yes, please describe)

Yes No

Describe any special features of the nanny/caregivers living area. (separate apartment,
basement room, kitchen, sitting room)

Approximate square footage of your home:

Please share any other comments you think would be helpful to us:

AGREEMENT


The Employer is aware that although Global Solid Care assists the Employer in referring a Caregiver to work in the employers home, we therefore cannot predict the candidates future behavior; actions or performance and only the employer can assess the Caregivers competence and appropriateness for the Employers position. The employer also understands that he/she takes full responsibility for the decisions to hire and to continue to employ the Caregiver and that the role of Global Solid Care is limited to supplying Caregivers for the Employers. The Employer at all times has the right to refuse hiring any candidate being considered during the referral process. The Employer shall refrain from making any private agreement with the Applicant or from taking any action which is inconsistent with this agreement or which has the effect of avoiding any of the Employers obligations hereunder. Such private agreements and actions include, but are not limited to, actions which would enable the Employer or any other person to avoid payment of the Placement Fees due to Global Solid Care, for example, if the Employer gives the name of one of our Caregivers to third party who subsequently hires the Caregiver. The employer is liable for the fee owed to Global Solid Care. Any breach of the conditions described herein will result in a monetary penalty being charged to the Employer, separate from the standard agency fee. Your application form will be assigned to a representative who will assess your requirements and provide you with assistance and guidance in matching you with the perfect nanny or caregiver. The representative will contact you for an initial consultation based on the information you provided.

I, the undersigned, have read the above and hereby certify and declare that all of the above information is true and that I have complete intention of hiring a nanny/caregiver.