EMPLOYER / PARENT APPLICATION FORM
*Required Fields
First Name *
Last Name *
Spouse's Name
Street Address *
City *
Province *
Postal Code *
Home Phone No.*
Cell Phone No.
Work Phone No.
Fax No.
Best time to contact
Email Address *
Confirm Email Address *
Your Occupation
Spouse's Occupation
Position you are hiring for:
 Note: We only place full time LIVE-IN nannies and caregivers across Canada.
Child Care - Nanny for children
Elderly Care - Caregiver for elderly
Special Needs - Caregiver for Special Needs or Disabled Person
Days and Hours work schedule (what are the days and hours you need the nanny /caregiver)
Nannies / Caregivers generally work 5 days a week.
Monday
 Tuesday
 Wednesday
Thursday
 Friday
Saturday
 Sunday
Total hours per week
Details of individuals to be cared for:
Name
 Age
 Relationship to employer
 Gender
 Disability
Male
 Female
Male
 Female
Male
 Female
Male
 Female
Male
 Female
Are you expecting?
 Yes
 No
Number of adults in house:
Duties Required:
Light housekeeping
 Full housekeeping
 Laundry
 Ironing
Meal preparation for children/elderly/disabled
 Meal preparation for entire family
Walk children to school
 Run errands
 Pets (feed, walk, etc.)
Other (specify)
Do any of your children / elderly require special care, medication or therapy? If yes, please specify.
Driver's Licence:
 not necessary
 preferred
 required
(Note: overseas nannies / caregivers must apply for driver's licence once they arrive in Canada if required)
Home Information:
# of bedrooms:
 # of bathrooms:
 Approx. Sq. Footage:
Other rooms:
Swimming Pool
Location:
 Urban(city core)
 Suburban (subdivision)
 Rural (countryside, small village)
Distance to :
 Public transportation - km
 Town/Shops/Store - km
Nanny / Caregiver Accommodation
Private bedroom
 Private bathroom w/shower
 Telephone
 Private TV
Cable
 Internet
 Other
Nanny / Caregiver's Wages
Salary: $
 per hour @
 hours per day;
 hours per week
Overtime:
 paid at 1.5x normal in excess of 44 hours per week
time-off in lieu of hours worked
When do you need the nanny/caregiver to start employment?
Duration of employment:
 From:
 To:
Additional Information:
Please state or describe any additional and responsibilities or other pertinent information not covered
in this application:
Where did you hear about THHCANADA INC. (formerly The Healthy Home Caregiver Services?
How many nannies /caregivers have you had in the past 3 years?
Please click the "submit" button once
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EMPLOYERS' ONLINE APPLICATION FORM
Dear Family / Employer:
Thank you for your interest in the service of THH CANADA INC. In order for us to give you the best possible service, we need to have you fill
out an employer application form so that we can assist you to find the right nanny / caregiver for your family. You can fill out this online
application form or you may download a copy and print it out on you computer (scan and email back to us). All information will be kept confidential.
THH CANADA INC.