Tyler Nanny Services Placement Agency
Application for Temporary Nanny or Sitter

To protect the privacy of your information this form is sent via secure transmission.

Contact name    Work phone

Spouse Work phone

Best place to reach you    Home phone  

Email address    Cell phone   

Fax number Attention  

Address

Area of town Major cross streets

Directions

Your profession or position at place of employment

Spouse's profession or position at place of employment

Child or children's name(s), date of birth, special needs (medical, transportation, etc)
1.

2.

3.

4.

List Nanny's duties relating to childcare
:

What pets are allowed indoors?

Will the nanny have any responsibility for pet care?  Yes   No
If so, what?

Do you have a backyard swimming pool? Yes   No

(It is customary to compensate a nanny for the use of her own car to run job-related errands or transport children)
If nanny’s vehicle is used for job related driving, will you reimburse mileage?  Yes   No

Are there any special circumstances in your household that the nanny should know about?
(Such as: divorce, blended family, addiction or behavioral problems, house for sale, religious beliefs, etc.)

Tyler Nanny Services will begin the search for candidates upon receipt of this completed form and payment of fees has been guaranteed. All fees are non-refundable. The first monthly fee is due when the interview is set up or services are provided.

Payment Method

VISA     MasterCard   Discover   American Express

Cardholder Name Credit Card Number

Expiration  Month: Day: Year:

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Tyler Nanny Services
Temporary Services Agreement

Please mark each paragraph box to indicate you have read and understood.

Please mark each paragraph box to indicate you have read and understood. I, (Please enter your name in the box) (hereinafter referred to as the “client” or “I”) agree to use the services of Tyler Nanny Services (hereinafter referred to as TNS) in this referral of a childcare provider to work in my household. Pursuant to the terms of this Agreement, Client seeks to retain TNS to make reasonable efforts according to applicable law to assist Client in finding a person or persons to provide in-home family services. Client understands and agrees that signing up with TNS or paying TNS fees does not guarantee that a suitable candidate will be found for the client.

1. In the event the Client hires or otherwise engages the services of a nanny that was referred or otherwise introduced to the Client, Client agrees to Pay a Referral Fee for EACH candidate Client elects to employ. . This fee is contingent upon hiring a candidate that TNS has referred to me. Signing this contract in no way obligates me to hire a candidate from TNS. If Client desires to hire a nanny in a long-term capacity, TNS will allow the client to apply temporary fees that have been paid to the agency within 60 days prior to client’s hiring the nanny, up to a maximum of $500, toward TNS long-term referral fees.

2. I understand that there is a $150.00 ANNUAL MEMBERSHIP FEE ($100.00 RENEWAL) for TNS temporary services. A $20 agency fee is charged for each nanny placement that is secured through the temporary on-call service. This fee will be charged on the card provided by the Client. Nannies are paid directly at the end of their assignments.

3. I understand, agree and accept that all candidates' profiles and files, which are received from TNS, are the property of TNS and the contents are confidential. I agree that I will not disclose to anyone the names, addresses, telephone numbers or vital information pertaining to any candidate. I understand that I am not to contact any candidate directly for the purpose of employment on a long-term or temporary basis. If, within three years of the date of the original referral I offer long-term or temporary employment to a candidate that TNS has referred to me permanent placement fee will be due to TNS. If I violate this provision and any information contained in the file is disclosed to a third party by me, and that third party hires the applicant, I agree to pay the placement fee of said applicant. In the event that TNS presses suit to enforce this provision, then the prevailing party shall be reimbursed for court costs and reasonable attorney fees.

4. Receipt of Fees: Should I hire a nanny through TNS I understand that the permanent agency fee is due when the offer is extended and accepted and it is required that payment is received at that time via credit card. I understand that I may prepay the permanent nanny placement fee by check or cash at the time of registration. My new employee will not be permitted to start work until TNS has received the full fee. All fees paid are non-refundable. Background Screening: A professional pre-employment screening firm performs TNS's searches. A nation-wide criminal check is run on all nannies that are hired on a long-term or short-term basis. These checks are important tools in screening out undesirable care providers; however, no combination of background checks is 100% fail-safe. References: TNS verifies the employment history on each applicant.

5. By signing this agreement I authorize TNS to charge the agreed referral fees to my American Express, MasterCard, Discover, or Visa credit card account at the time of fulfillment of request for temporary services.

  • MEMBERSHIP FEE $150.00
  • ANNUAL RENEWAL $100.00
  • AGENCY FEE PER PLACEMENT: $20.00 (PER DAY)
  • AGENCY FEE PER OVERNIGHT PLACEMENT: $35.00 (PER NIGHT)
  • AGENCY FEE PER HOTEL PLACEMENT: $35.00 (PER DAY

In addition to the above agency fees, Client will pay nanny directly at the end of the assignment. SEE “ PERMANENT SERVICES APPLICATION” FOR FEE SCHEDULE ON PERMANENT REFERRALS.

6. Client Acknowledgment and Release: TNS is a referral agency and does not maintain an employer/employee relationship with any candidate. TNS will exercise its best efforts in referring the most suitable candidates but cannot make any guarantees; expressed or implied, regarding the performance of the person referred to me and subsequently employed by me. There shall be no additions, deletion, or modifications made to this contract. I understand that TNS does not have any control over the services provided by the candidate.

7. I release and discharge forever Tyler Nanny Services, its respective officers, directors, agents and employees from all actions, causes of action, claims and demands for injuries, accidents, sickness, and damages of whatsoever nature, whether known or unknown, which may be sustained by me or my dependent arising out of the performance or nonperformance of the candidate (my employee.) I, hereby agree to indemnify and save harmless TNS from all injuries, losses, damages and expenses, should any claim, demand or suit be made by me on behalf of my child or children, ward of parent(s).

I have read and I accept this agreement and I have retained a copy for my personal records.

Today's Date: Month: Day: Year: