Parents registration

Please fill in this form to apply for a child carer.

Personal Details

Title

Title (other)

First Name (required)

Surname (required)

Address (required)

Town

Post Code (required)

Home Phone (required)

Work Phone

Mobile

Contact Email (required)

Nationality (required)

Main Language Spoken at Home (required)

Other Languages Spoken

Number of Adults in Family (required)

Number of Children in Family (required)

Boy's ages (if applicable)

Girl's ages (if applicable)

Baby due date (if applicable)

Father's Occupation

Mother's Occupation

Other Staff in Household

Animals in Household

Do any Household Members smoke? (required)

Requirements

I require a (required)

Contract type (required)

If temporary, duration of post

Further details e.g.; number of days, hours etc.

Type of charge (required)

Commencement date (required)

Driver required

Preferred age range of nanny

Personality

Duties (required)

Please state any special requirements

Employment Details

Accommodation offered if live in

Weekends free (required)

Evening babysitting (required)

Travel with family (required)

4 weeks holiday per annum (required)

Use of car provided (required)

Interview expenses reimbursed (required)

Medical insurance provided (required)

Service Package Required

Please indicate what service package you require from the Agency; (required)

How did you hear about us?

Disclaimer

I confirm that the information on this online form is accurate and supplied in good faith to the best of my knowledge and belief and furthermore, I have read The Agency's Terms and Conditions of Business and agree to be bound by them and to pay the Agency's fees and charges in accordance with those Terms and Conditions of Business. I request The Agency immediately to endeavour to find a suitable employee(s) for me.

By submitting this application you are agreeing to the Terms and Conditions of Business set out in the previous pages. Please tick this box to confirm that you have read and accept these terms and conditions.

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