Household Staffing Application

Employer Information
Name:*
First Last
Email Address:*
Phone Number:*
Occupation:
Secondary Contact Name:
First Last
Secondary Contact Email Address:
Secondary Contact Phone Number:
Secondary Contact Occupation:
Home Address:*
Street Address Address Line 2 City State ZIP Code
Secondary Address:
Street Address Address Line 2 City State ZIP Code
Please describe your home and family (size, # of bedrooms, # of levels, style, housekeeping style, # of people living in the home):*

Client Agreement
Agree to our terms:*
I understand that if I hire a candidate that has been presented by Boston Nanny Centre and/or utilize the screening materials of said candidate, I will be responsible to pay a placement fee to the agency. Upon receipt of my application Boston Nanny Centre will send me an employer/agency contract, which further explains the payment schedule and replacement policy. Before a search is begun, I agree to return a signed copy of the contract to Boston Nanny Centre. I have read the agreement above and by entering my initials in the box below, I agree to adhere to it.
Name
This field is for validation purposes and should be left unchanged.

Employer Information