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Address
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Nationality
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Single
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What sort of work are you looking for?
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Live-in nanny
Daily nanny
Mothers help
Babysitting
Temporary or Permanent
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Temporary
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Full or part time
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Full Time
Part Time
From when are you available?
If temporary, until what date are you available?
Are you willing to work weekends?
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Yes
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Do you hold a childcare qualification?
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Yes
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If yes, what?
Do you hold any other relevant qualifications?
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Yes
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If yes, what?
How many years experience do you have?
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Do you currently have an up to date CRB?
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If yes, when was it carried out?
Preferred age of children to work with?
Preferred number of children
Do you drive?
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Yes
No
If yes, do you have a car you are prepared to use for work?
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Yes
No
Do you hold a full, clean, UK driving license?
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Yes
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If no please give further details
Prepared to do light house work?
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Yes
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Are you happy to work in a household with pets?
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Yes
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Can you cook?
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Yes
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If yes, up to what standard?
Can you swim?
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Yes
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If yes, up to what standard?
What net salary are you looking for?
Per
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Hour
Day
Week
Month
What are your hobbies?
Describe yourself in three words:
Do you have any disabilities that you feel could affect you while you are working?
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Yes
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If yes, please explain
How many sick days have you had in the past year?
Employment Details: Please start with your most recent employers:
Start Date
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Select month
01
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Select year
1950
1951
1952
1953
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2001
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2008
End Date
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Select month
01
02
03
04
05
06
07
08
09
10
11
12
Select year
1950
1951
1952
1953
1954
1955
1956
1957
1958
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1963
1964
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1966
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1968
1969
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2006
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2008
Name
Address
Telephone Number
Postcode:
Ages of Children
General Responsibilities
Reason for leaving:
Salary
Start Date
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01
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31
Select month
01
02
03
04
05
06
07
08
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11
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Select year
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
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1964
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1966
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1991
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1995
1996
1997
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1999
2000
2001
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2004
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2008
End Date
Select day
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31
Select month
01
02
03
04
05
06
07
08
09
10
11
12
Select year
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
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1991
1992
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1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Name
Address
Telephone Number
Postcode:
Ages of Children
General Responsibilities
Reason for leaving:
Salary
Start Date
Select day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
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30
31
Select month
01
02
03
04
05
06
07
08
09
10
11
12
Select year
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
End Date
Select day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
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23
24
25
26
27
28
29
30
31
Select month
01
02
03
04
05
06
07
08
09
10
11
12
Select year
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
Name
Address
Telephone Number
Postcode:
Ages of Children
General Responsibilities
Reason for leaving:
Salary
Are you registered with any other agencies?
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Yes
No
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