Personal Details

Name

Email

Home Tel

Work Tel

Skype ID

Mobile Tel

Address

Mothers Occupation

Fathers Occupation

Family Details

Marital Status

Mothers Nationality

Fathers Nationality

Family Religion

Family Residence

Other, please state

Number of Children

Ages and Sex

Any children with special needs? please state?

Do you have any pets?
YesNo

Type of Staff Required

If live in, please describe accommodation

Languages to be spoken

Previous Experience

Car Driver

Non Smoker

Start Date

Length of Stay

Net weekly salary offered

Childcare Responsibilities

Hours of Work/weekly

Shared Care
YesNo

Sole Charge
YesNo

Both parents at work
YesNo

Any Babysitting
YesNo

If Yes, how many evenings a week

Nursery Duties only
YesNo

Any Extra Duties
YesNo

Please state

Additional Info - Please give below any additional information or benefits you may feel will be helpful in finding the most suitable staff for your family (for example accommodation, car, holidays, second residence).

How did you hear about us?

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