Mercare Applicant Questionaire
Questionnaire
Desired Position
Desired Position
(Required)
Nanny
Caregiver
Job Type
(Required)
Full-Time
Part-Time
Job Location
(Required)
Live-In
Live-Out
Personal Info
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Age
(Required)
Gender
(Required)
Male
Female
Other
Highest level of education?
(Required)
High School
Associate Degree
Bachelor’s Degree
Graduate or Professional Degree
Some College
Other
What languages can you speak?
(Required)
English
Spanish
French
Mandarin
Arabic
Hindi
Portuguese
Japanese
German
Korean
Italian
Dutch
Turkish
Thai
Vietnamese
Other
Other Languages
(Required)
If your language is not listed type it here.
Valid Driver's License?
(Required)
Yes
No
Temporary
Swim Ability
(Required)
Non Swimmer
Weak
Average
Strong
Are you comfortable with heavy lifting?
(Required)
Yes
No
Can you cook meals?
(Required)
Yes
No
Can you do light housework?
(Required)
Yes
No
Ready to do companionship?
(Required)
Yes
No
Willing to work weekends?
(Required)
Yes
No
Mobility support?
(Required)
Yes
No
Homework help?
(Required)
Yes
No
Errands/Shopping?
(Required)
Yes
No
Smoking Status
(Required)
Yes
No
Comfortable with Pets?
(Required)
Yes
No
How many children can you take care of alone
(Required)
Photo
(Required)
Accepted file types: jpg, png, Max. file size: 1 MB.
Phone
This field is for validation purposes and should be left unchanged.