Client Application Client Application for Childcare Promo Code Your Name(Required) First Last Name of Spouse/Partner First Last Email(Required) Phone(Required)Alternate PhoneAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Is your home accessible to public transportation?(Required) Yes No Which train or bus line?(Required) What is your profession?(Required) What is your spouse or partner's profession? Does any parent work from home?(Required) How can we get to know you?(Required) Google Meets Consultation Only by Phone Does your family have a pet(s)?(Required) Yes No Please Describe Your Pet(s)(Required)Name(s) of Pet(s)(Required) Add RemoveDoes your nanny need to care for your pets?(Required) Yes No What type of nanny are you looking for?(Required) Full-time (more than 30 hours per week) Part-time (less than 30 hours per week) Full time Household Manager What placement search are you interested in?(Required) Mag Mile Package (1 year guarantee) Skyline Package (6 month guarantee) Second City Package (3 month guarantee) What are the days and hours needed?(Required)Day(s)Hour(s) Add RemoveWhat is the hourly rate you are seeking to pay?(Required) Payment(Required) Cash W2 Desired start date of nanny, if any? MM slash DD slash YYYY Are you open to a manny?(Required) Yes No What household responsibilities are required of the nanny?(Required)Check all that apply Make child(ren)’s bed Child(ren)’s laundry Child(ren)’s meals Clean child(ren)’s toys Light housekeeping Carpool Transport child(ren) Shopping for child(ren) What duties from this list applies to your search–which is NOT part of a nanny's regular duties, and should be negotiated between the family and the nanny?(Required)Check all that apply Travel with family Pet care Run errands Grocery shop Vacuuming and dusting Family meal preparation Make family’s beds Family laundry Plant care Other Please specify other duty(ies).(Required) Is driving required of your nanny?(Required) Yes No How many children will she/he care for?(Required)What are the names of your children?(Required)Include their gender and age. NameGenderAge Add RemoveDoes your child(ren) require special needs such as: health, behavioral, emotional or academic concerns?(Required)How many paid vacation days will you offer?(Required)How many sick or personal days will you offer?(Required)Are you interested in setting up a nanny work agreement? Yes No How did you hear about Second City Nannies?GoogleFacebook GroupFriendLakeview Pediatrics
