Fields marked with * are mandatory.     
Date:*
Parent/Guardian's Name:*
Current Address:*
Day Phone:* Cell Phone:
Fax: 
Email:*
Parent/Guardian's Occupation:*
Which Angel Care Package will you be choosing? Please fill out credit card information below.
($45 per month) With the option of canceling at anytime.
($240.00) $40/month = $30 savings.
($440.00) $40/month = $60 savings + 1 month free!!!

How many children do you have?  What are their ages and gender?

Will your nanny be expected to cook for the children or family?
Does your family have any dietary considerations? 

Describe your residence:  private home, apartment, townhome, or other.
How did you hear about us?  
 
Angel Care Babysitting Registry Fee Agreement

If you are a new client, there is a $35 one time sign up fee for joining Angel Care Nanny Agency.
Angel Care’s Membership Packages are non-refundable.
For the month to month registry membership, $45 will be deducted automatically from your account each month on the day you’ve signed up.  If you wish to cancel your account, you can do so manually from Paypal or you can call Angel Care Nanny Agency and we will be happy to assist you.


To activate your membership, please fill out the credit card information below. Your credit card will be charged a $35 one-time activation fee. If you cancel your membership and choose to re-activate at another time, the activation fee will apply.

Billing Information - Please enter the following information exactly as it appears on the customer's credit card.

Country:
First Name:
Last Name:
Card Type:
Card Number:
Expiration Date:
Card Security Code:
*The security code is the 3 digit number on the back of the credit card. If you are using an American Express card, the 4 digit security number appears on the front, above the card number.
Address Line 1:
Address Line 2:
City:
State:
ZIP Code:
Email Address:
Day Telephone:

 

1. SERVICES:
At the client's request, Angel Care Nanny Agency (ACNA) will seek out, recruit, research and screen appropriate candidates for a position. (ACNA) acts only as a referral service and does not hire or employ any employee. The employee is to be hired, employed, and paid by the client only.  Our clients are encouraged to complete their own due diligence in screening candidates to care for their children.
 

2. REPRESENTATIONS:
ACNA will use reasonable efforts to refer qualified candidates to the client; however, it does not guarantee the credentials or performance of, or client satisfaction with any candidate.  If the client is dissatisfied for any reason, recourse to ACNA will be limited to a credit toward a future placement fee, as specified above.  The client agrees to identify ACNA and hold it and all of its directors, officers, employees and agents harmless from any costs or expenses arising out of any claim against ACNA relating in any way to a candidate's employment.


FAMILY AGREEMENT

I have contacted ACNA to help me find household help. I have reviewed the fee options and agree that if I employ a candidate referred to me by ACNA, I will pay ACNA the referral fee in full as further detailed herein, before the candidate begins working for me. A deposit of 50% is due to ACNA immediately upon reaching an agreement of employment with the candidate with the balance due five (5) business days prior to candidate’s first day of work.

I agree to hold in confidence the identity of all candidates referred by ACNA and the contents of any files or documents forwarded to me for the purpose of review.  I further agree that all such files, comments and their contents remain the property of ACNA and agree not to make copies or reproduce the contents, in whole or part; and upon request, I will return them promptly to ACNA.  If I disclose any information about a candidate to a third party, and acting on that information, the third party subsequently employs the candidate, I undertake to pay promptly to ACNA the full placement fee that would have been payable for that candidate.

I understand that ACNA has invested in the interviews and background checks of the candidates and I will allow them to act as the placement referral agency.

If you agree to the terms listed above type "Yes" in this box: 

 

Thank you for your time in completing this application.