Values questionnaire (Section 1 of 4)

What are you, as an individual, passionate about?	What/who inspires you?
What values and qualities do you wish your Nooks & Nannies staff to exemplify?	What values do you want to pass on to your children?
Reverse qualities: List several behaviours that you do not like, and then reverse them to see more values that are important to you. Examples: rudeness/politeness. aggression/peacefulness.	Describe your most treasured moment.
What activities do you love to participate in? What are the qualities that you love about your best friends?	What in life is important to you? Give some examples of situations, i.e. previous jobs that were not positive experiences for you, and then list the reverse quality. For example, controlling supervisor/need for autonomy. Lateness/promptness.

Details (Section 2 of 4)

Please provide us with details about the tasks and services that you can offer to a potential family.

Part time or full time? Full time      Part time	Would you be able and willing to work evenings, weekends, and overtime if necessary? Yes      No
If part time, what days? Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Applicant information (Section 3 of 4)

Last name:	First name:		Middle initial:
Language(s) spoken at home:	Smoker?
Street Address:	City:	Province:	Postal code:
Phone number:	Email address:
Secondary phone number:	Secondary email address:

Tasks and services (Section 4 of 4)

Please let us know what kind of work you can offer.

Housekeeping	✓	Comments
Cleaning
Cooking
Dog walking/pet care
Errands
Gardening
Ironing
Laundry
Secretarial (planning/coordinating)
Shopping
Tidying
Meal Planning
Other

Child care	✓	Comments
Waking/dressing children
Changing diapers/toilet training
Morning routine
Feeding bottles/snacks/meals
Before school care
Dispensing vitamins/medicine
Transporting children
Nap time
After school care
Helping with homework/reading together
Outdoor activities
Crafts
Music
Extracurricular classes/sports
Bathing/personal hygiene
Bed time routine
Other

Thanks for your application

We sincerely thank all applicants. Nooks & Nannies will contact those who are successful, to arrange an interview.