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Mothers Name
Fathers Name
Address
Nearest tube station
Home phone
Business phone
Mobile phone
Email
Preferred contact
Fathers occupation
Mothers occupation
Religion
Are you registered with another agency? If so, which?
Child 1
Child 2
Child 3
Child 4
Please describe your current care arrangements for children. When and why are they ending? sss
Type of carer required (please tick one box)
Live in nanny Live out nanny Mothers help
What kind of personality would best fit your family's needs?
Is the position sole charge? Yes No Please select
Start date End date
Days per week required (please state if flexible)
Exact hours per week required: From Until
Salary offered (net per hour, per day or per week)
Are you interested in:
- nanny-sharing with another family? Yes No
- nanny-sharing using a nanny? with her own child? Yes No
Do you require a driver? Yes No Please select
If so, will a car be provided? Yes No Please select
Must your carer be a non-smoker? Yes No Please select
Do you have any pets? Please detail
Do your children have any special dietary needs or allergies?
If the position is live in, please describe the accommodation
Please ensure that you read our Terms of Business - click here
I confirm that the details above are true and accurate and that I have read and understood the Terms of Business Tick box
Date
