Application for Employers Online Please fill out the online form below. Local Please complete this printable form and fax or mail it to:Reliable Nanny and Caregiver Placement Agency110-3528 Vanness Avenue,Vancouver, BC V5R 6G4CanadaFax: (604) 435-3165 Details of Position Position Offered Expected Start Date Salary Offered Your Information Full Name (required) Address (required) Phone Number (required) Email (required) Occupation Family Composition No. of Adults No. of Children Children Information Elder Information Special Requirements Home Description Nanny/Caregiver Accommodation Days off Hours of Work Driver's license required? Yes Nanny's Car Pet Information Nanny's Qualities Outline of duties Length of employement Δ