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Manhattan Office
40 Wall Street
28th Floor
New York, NY 10005
Phone: (212) 400-7157
Rockland County Office
39 Demarest Avenue
West Nyack, NY 10994
Phone: (845) 348-7080
Nassau Office
1225 Franklin Ave
Suite 325
Garden City, NY 11530
Phone: (516) 240-8034
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Hotel Care Application
It's our pleasure to help you find the best caregiver that fits your family needs. The information you provide will help us select the perfect caregiver for you.
We do require a non-refundable $30 application fee be paid prior to our reviewing your application. You will be directed to Paypal immediately after completing the form. Once the application is received, and the application fee paid, we will then call or e-mail you and start the hiring process.
Please answer all questions completely as possible.
Step 1 of 4 - Client Information
25%
Client Information
What type of service is needed?
*
Nanny
Newborn Care
Elderly Care
Parent 1
*
First
Last
Parent 1 Mobile#
*
Email Address
*
Office Phone Number
*
Office Fax Number
Is there a second parent?
*
Yes
No
Parent 2
*
First
Last
Parent 2 Mobile#
*
Parent 2 Office Phone Number
*
Parent 2 Office Fax Number
Present Home Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Home Phone Number
Hotel Name:
*
Hotel Address:
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Room #
*
Dates of Hotel Stay: (Checkin to Checkout)
*
Children's Information
Child's Name
*
First
Last
Birth Date
*
Grade (if applicable)
Special Interest/Hobbies:
*
Is there a second child?
*
Yes
No
Child #2 Name
*
First
Last
Child #2 Birth Date
*
Child #2 Grade (if applicable)
*
Child #2 Special Interest/Hobbies:
*
Is there a third child?
*
Yes
No
Child #3 Name
*
First
Last
Child #3 Birth Date
*
Child #3 Grade (if applicable)
Child #3 Special Interest/Hobbies:
*
Is there a fourth child?
*
Yes
No
Child #4 Name
*
First
Last
Child #4 Birth Date
*
Child #4 Grade (if applicable)
Child #4 Special Interest/Hobbies:
*
Are there additional children?
*
Yes
No
Please provide names and birth dates of additional children.
*
Do any of the children have special needs?
*
Yes
No
Please describe your child's special needs:
*
Are there any dietary restrictions?
*
Yes
No
Please explain dietary restrictions:
*
Do your children attend preschool, day care or special lessons?
*
Yes
No
Please explain:
*
Please provide any additional information you want us to know:
Home Environment
Are there any pets?
*
Yes
No
Please describe (how many, type, breed)
*
Does anyone smoke in the home?
*
Yes
No
Caregiver Qualifications
Will your caregiver stay at the hotel?
*
Yes
No
Check all the accomondations that apply:
*
Private Room
Shared Room
Private Bath
Shared Bath
Paid Travel Expenses
Phone
T.V.
Days Needed
*
Monday
Tuesday
Wednesday
Shared Bath
Friday
Saturday
Sunday
Please describe hours needed or schedule:
*
Describe your ideal caregiver:
*
What responsibilities will the caregiver have?
*
Will you need house keeping?
*
Yes
No
Please describe house keeping needed:
*
Will you need laundry done?
*
Yes
No
Please describe the laundry that will need to be done:
*
Will the caregiver need to cook for...
*
Children only
Entire Family
No Cooking Involved
Have you ever employed a caregiver before?
*
Yes
No
Reason(s) for the caregiver leaving:
*
What did you like about your previous caregiver?
*
What did you dislike about your previous caregiver?
*
Is there any additional information you want us to know?
How did you hear about Tender Loving Nannies?
*
Hotel Care Application Fee
Hotel Care Application Fee
$0.00
A non-refundable application fee must be received prior to us reviewing your application. You will be directed to Paypal once you click "Submit" below.
