Oregon Nannies: Parent Inquiries

Oregon Nannies, Inc.
2170 Bedford Way
Eugene, Oregon 97401
Voice: 541-343-3755
Fax: 541-345-9412
onannies@oregonnannies.com

General Information:
Father		Mother
Fax		Telephone
Location of Work		Email
Address
Shipping Address
Father's Job		Phone
Mother's Job		Phone
Parent's Personalities
Child 1:
Name		Age
Personality
Child 2:
Name		Age
Personality
Child 3:
Name		Age
Personality
Child 4:
Name		Age
Personality
Child 5:
Name		Age
Personality
Nannie's Duties:
Hours		Days Off
Starting		Eves/Wknds
Please check all of the following that apply:
	Children's Meals		Clean Up
	Other Meals		Clean Up
	Drive Children to School/Activities		Children's Laundry
	Family Laundry		Ironing
	Bathe Children and put to bed		Shopping and Errands
	Children's Bathroom		Maintain Children's Room
	Care for Pets		Heavy Cleaning
	Vacations		Travel With Family
	Other Responsibilities
Other Information:
Pets in House	Yes No	Smokers in Home	Yes No
Living Arrangements
Special needs, circumstances
Health Insurance		Health Club
Car
Salary Range		Benefits Paid by Employer
References:
Do you currently have a nanny?
Would you like to use her as a reference?
Personal References:
Name		Phone
Name		Phone

Thank You!