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EMPLOYMENT APPLICATION
PERSONAL INFORMATION
Job Applicant Full Name: MARIATOU B.
Address: Germantown, MD 20876
Home Phone #: Withholding for now
Cell Phone #: Withholding for now
Marital Status (Not mandatory): Married
Number of children: Two, ages 2.5 years and four year old
Faith or Religion (Not mandatory): Muslim
GENERAL INFORMATION
Are you 18 years or older? Yes - 42 years of age
If employed, could you submit proof of your legal right to work in U.S. to your employer?
Yes, has a Worker Permit (Employment Authorization Card)
Do you have at least two years of recent experience as a nanny or domestic worker? No - 8
month experience working with children but has two children of her own, ages, 2.5 years and 4 years
Do you speak English? Yes
Do you speak a fluent language other than English and if so, please list the language? Yes -
French (Willing to share French with children on an informal basis)
Do you have a driver's license and do you have your own vehicle? Yes, has a driver license but
at this time does not have a car - Husband can drop off/pick up applicant from work weekdays
If applicable, list the state you have your driver's license: Maryland
List driving violations and dates if applicable: None
Do you wish to drive child/ren or adult in your vehicle while they are in your care? Yes
If yes, do you have adequate vehicle insurance? N/A
Do you prefer your employer provide you with a vehicle for job-related duties? Yes
Are you CPR certified for infants/children or adults and if so give us the certification exp. date?
No
Are you a smoker or a non smoker? Non smoker
If applicable, please let us know how many children you will care for and their ages? One or two
children, ages from infant up to 5 years or older
Do you need to bring your children to work with you and if so, please list your children's age? No
For elder care or companion care candidates, please briefly describe what you are looking for.
N/A
DESIRED EMPLOYMENT
List the type: Nanny, babysitter or nanny/housekeeper for full-time, live-out and long-term
employment
Nanny, babysitter, nanny/housekeeper, full-time, live-out
EMPLOYMENT AVAILABILITY/RELOCATION INFO
Are you available for work Monday thru Friday or other days? Yes - Monday thru Friday
(Weekends off)
List the available hours: From 9:00 AM to 5:00 PM (May be able to start earlier at 7:00/8:00 and
get off at 3:00/4:00 PM if needed)
List locations you are willing to consider for work: Germantown, Clarksburg, Gaithersburg, Darnestown, Potomac, Rockville
Can you work overtime, if needed? Perhaps, will discuss this with employer but will need extra
pay for overtime work
Do you want to relocate for work in the U. S. and if so, list locations you will consider for
employment? No
If applicable, are you willing to pay travel, lodging & food expenses as part of your relocating
costs? N/A
If hired, when can you start work? Looking for immediate hire
DESIRED SALARY & EMPLOYEE BENEFITS
List salary expectations for a weekly or daily work schedule: $350/week (40 hours) or $12/hour for part-time work at a minimum of 20 hours/week (Will need to discuss tax
issues prior to starting employment) - Rate reflects care of one child and if time is not taken
away from the child is open to light housecleaning and cooking family meals - Open to learning
Indian cooking if given proper instructions in this area.
List desired benefit package (if offered): Prefer to have federal holidays off with pay, have one week
vacation paid
If applicable, list live-in accommodations you will consider: N/A
EDUCATIONAL BACKGROUND INFORMATION
Did you graduate from high school in the U.S.? No
If you went to school in another country other than the U.S., list nation: Guinea, Africa
Did you graduate from college and if so, list the year you graduated and your major: No
Are you currently a student and if so, please list your area of study, the days and hours of your
classes: N/A
Please list a person's contact name and phone number in case of an emergency:
Husband/Withholding phone number for now
Have you ever been convicted of a felony? No
WORK REFERENCE FORM
LIST WORK REFERENCES
(1) LIST THE NAME OF YOUR EMPLOYER: Aminata T.
LIST EMPLOYER'S PHONE NUMBER: Withholding for now
LIST JOB LOCATION: Silver Spring, MD
LIST DATES WORKED: From 11/08 to 05/09
LIST YOUR JOB TITLE: Nanny
LIST JOB DUTIES: Nanny
LIST CHILDREN'S AGES: 1 and 3 years (Two children)
WHY DID YOU LEAVE THIS JOB? Job ended
EMPLOYER COMMENTS: Talked to the above employer on 7-9-09 - She highly recommends
Mariatou for future employment and can be fully trusted when left alone tending to children.
(2) LIST THE NAME OF YOUR EMPLOYER: Kadiatou D.
LIST EMPLOYER'S PHONE NUMBER: Withholding for now
LIST JOB LOCATION: Gaithersburg, MD
LIST DATES WORKED: From 09/08 to 11/08
LIST YOUR JOB TITLE: Nanny/Housekeeper
LIST JOB DUTIES: Cared for children, and helped with housecleaning
LIST CHILDREN'S AGES: 1, 2, 3 & 4 years (Four children)
WHY DID YOU LEAVE THIS JOB? Job ended
EMPLOYER COMMENTS: Talked to the above employer on 7-9-09 - She highly recommends
Mariatou for future employment tending to children and helping out around the home with
housecleaning duties as well.
If you would like to meet with Mariatou B. in a job interview then contact our company to check to see if she is still available for employment. If she is available then we ask that you SIGN UP with our service by using our online Family Application. See below for this link. Thank you - We look forward to hearing from you!
CONTACT INFORMATION
FAMILIES HELP LINE
Office Telephone: 301-868-4420 (It is best to call between 9:00 a.m. and 5:00 p.m., EST, Monday through Friday.)
Send us an e-mail! (It is best to contact us after work hours and on weekends by e-mail.)
APPLY ONLINE
CLICK HERE!
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