Happy Kidz Nanny Application


Nanny/Babysitter Application Yes No

Please provide the following contact information:  (All fields required)

Name (First,Last)
Street Address       
Suite/Apt #            
City, Province        
Zip/Postal Code     
Country                 
Daytime Phone      
Evening Phone       
Cell Phone             
Email (required):  

Please provide the following personal information:  (All fields required)

Date of Birth (Month/day/Year)
Sex Male Female
Are you currently Employed? Yes No
Do you have any Allergies? Yes No
If yes, please describe?
Are you First Aid certified? Yes No
Are you CPR certified? Yes No
If not certified are you willing to? Yes No
Do you drive? Yes No
Do you own a car? Yes No
Have you had any accidents? Yes No
Do you smoke? Yes No
Do you swim? Yes No
Do you have a clean criminal record? Yes No
Do you have a criminal record check? Yes No
Are you legally allowed to work in Canada as a babysitter? Yes No
SIN #  (only for sole purpose of ensuring eligibility to work in Canada)
What is your Status in Canada? ie. citizen, work visa etc.

When and where are you available to work?  (All fields required)

Are you looking for?  Full-time Anytime Part-time
In Which Area are you willing to work ?                                                      

  Vancouver    Burnaby    North Vancouver  West Vancouver

Richmond     New West   Port Coquitlam      Coquitlam         

Port Moody  Langley      Surrey/Delta          Maple Ridge     

Abbotsford  White Rock                                                                

 

What times are you available for work?   (All fields required)

Monday?

morning    afternoons    evenings    overnight

Tuesday?

morning    afternoons    evenings    overnight

Wednesday?

morning    afternoons    evenings    overnight

Thursday?

morning    afternoons    evenings    overnight

Friday?

morning    afternoons    evenings    overnight

Saturday?

morning    afternoons    evenings    overnight

Sunday?

morning    afternoons    evenings    overnight

                Childcare References   (All fields required)

 

                                    Reference #1

Name of Employer
Address of Employer
Phone # of Employer
Number of Children
Age of Children
Date you worked for the family
Was it PT/FT or on Call Position?
Describe your duties
What were your activities w/the children?

                                Reference #2

Name of Employer
Address of Employer
Phone # of Employer
Number of Children
Age of Children
Date you worked for the family
Was it PT/FT or on Call Position?
Describe your duties
What were your activities w/the children?

Please give us a brief description of your Childcare experience

 
Do you have experience working with?

 

 

Newborns (0-3 months)

Infants      (4-12 months)

Toddlers  (1 year-4 year)

How did you hear about us?

 

Terms & Conditions

1. These Terms and conditions shall represent a legally binding contract between HAPPY KIDZ CAREGIVERS and the caregiver.
2. All correspondence and records shall be confidential and remain the property of the Agency. Information supplied by the Agency is confidential and is accepted by the caregiver on the condition that such information will not be disclosed to any third party.
3. Should a caregiver affect any form of introduction, direct or indirect, of a client to a third party, or pass on any details resulting in permanent, temporary or part-time employment, the caregiver will be responsible for the full placement fee. If a caregiver accepts a position referred to and/or provided by the client or referred to by the client either in their home or third party home, caregiver will be responsible for the full placement fee.
4. The Agency accepts no liability of any kind for any kind for any inconvenience, loss or damage of property, or any loss or injury howsoever arising directly or indirectly from any act or omission of any applicant introduced by the Agency even if such an act or omission is negligent or fraudulent or reveals dishonesty. 
5. The caregiver agrees to notify the Agency immediately an engagement has been and to supply details to the Agency of the date of commencement and length of employment and agreed wages. 
6. Should a short-term engagement be extended by the Client, or by any applicant be re-arranged at any future time, the appropriate additional fee shall become payable. The Agency must be notified immediately of any such changes. 
7. Should any applicant recruited as an evening babysitter be employed for daytime work, the agency must be notified immediately. 
8. The agency does not employ caregivers introduced and any contracts of employment entered into between the client and the caregiver are between those persons directly. The client is responsible for complying with all employment, fiscal and other relevant legislation. 
9. It is the caregiver's responsibility to notify the agency when accepting a job. If the caregiver fails to report to any confirmed jobs, she will face disciplinary measures, which may include suspension from the Agency. 
10. If the caregiver becomes ill or if an emergency arises, she must contact Happy Kidz Caregivers immediately. Under no circumstances is a caregiver to pass on a job without the consent of Happy Kidz Caregivers. 
11. Caregivers who do not give the Client at least 24 hours notice prior to canceling a job will be suspended. 
12. Caregiver are employed solely by the Client and are not employees of the Happy Kidz Caregivers. Caregivers are independent contractors and will not be give a t4 at the end of the year and are solely responsible for paying their own taxes.
13. Happy Kidz Caregivers makes no representations to caregivers or clients concerning the nature of the service provided. The Client and caregiver acknowledge that Happy Kidz Caregivers is not responsible for, and will be held harmless against, any injury, loss, or other damage arising from or related in any manner to the Client or caregiver's use of the Happy Kidz Caregivers Agency.
14. If a caregiver knowingly deceives Happy Kidz caregiver by accepting employment within 1 yr of last booking with client and without the knowledge of Happy Kidz caregivers, the caregiver can and will be held responsible for all outstanding fees regarding agency placement/hourly rates. It is required that the caregiver inform Happy Kidz caregivers immediately when they are offered additional employment from clients. All outstanding fees are to be charged to the babysitter and paid to Happy Kidz within 5 business days.

This agreement is binding under and subject to the laws of the Province of British Columbia, and is understood and accepted by the undersigned party.

I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND AND AGREE TO THIS CONTRACT IN ITS ENTIRETY. THIS AGREEMENT IS BINDING AND SUBJECT TO THE LAWS OF THE PROVINCE OF BRITISH COLUMBIA, AND IS UNDERSTOOD AND ACCEPTED BY THE UNDERSIGNED PARTY. ANY LEGAL FEES AND COURT COSTS INCLUDING REASONABLE ATTORNEY'S FEES INCURRED IN COLLECTING ANY MONIES DUE TO HAPPY KIDZ CAREGIVERS AT ANY TIME WILL BE THE SOLE RESPONSIBILITY OF THE CAREGIVER. SHOULD ANY TERMS BE BREACHED IN THIS AGREEMENT (IE. PLACEMENT IS ACCEPTED WITHOUT THE CONSENT OF THE AGENCY) BY THE APPLICANT.  FULL AGENCY FEES + $500 BREACH OF CONTRACT FEE WILL BE CHARGED ON TOP OF ALL COLLECTION AND COURT RELATED FEES.

Nanny/Babysitter is an independent contractor.  Nanny is responsible for his/her                     
own taxes, therefore Agency will not be issuing a T4 at the end of the year. The nanny           
agrees that by submitting this application all information in this form is correct                      

 and all Terms & Conditions have been read and agreed to.                                  .                   

Date                                                                      
Signature


Happy Kidz Caregivers.
Revised: September 09, 2008