~Membership Form~ $15 for one year of Membership Method of Payment:______________ Date: _________ Name: ____________________________________________________ E-mail: ___________________________________________________ Address: __________________________________________________ City: _________________________ State: _________Zip: ___________ Home Phone Number: _________________________________________ Cell Phone Number: __________________________________________ Birthday: _____________ How long you’ve been a nanny: __________ Are you a Live-in or Live-out Nanny: _____________________________ (If a Live-Out Nanny what City/State do you work in): _________________________________________________________ How long have you been a Nanny: ________________________________ Ages and Gender of your Charges: _______________________________ How did you come across our group: ______________________________ Please list your Hobbies/Interests: ___________________________________________________________ _______________________________________________________ Anything else you’d like to add: ___________________________________________________________ _______________________________________________________ *Please mail this completed form along with your check~ ~made payable to Andrea Flagg/Nanny Alliance of NY & NJ Nanny Alliance of NY & NJ PO BOX 851 Saddle River, NJ 07458 www.nannyalliancenyandnj.com info@nannyalliancenyandnj.com |
