Nannies Plus Application

 

Nannies Registration Form
Please fill in the details below in order to register with Nannies Plus LTD . All details will be treated with strictest confidence, and no details will be disclosed to any other parties, barring potential employers.

 

Personal Details

Title :
First Name :
Surname :
Maiden Name :
Address :
Previous Address (within the last 2 years) :
Home Telephone :
What time can you be contacted :
Mobile :
Work Telephone :
Is it discrete? Yes  No
Email :
Age :
DOB :
Marital Status :
Nationality :
Religion :
Do you have any children? Yes  No
What are their ages :
Do you have any brother and sister? Yes  No
What are their ages :
Name,Tel No. and Address of next of Kin :

 

Further Details
Do you own a passport? Yes No
Do you smoke? Yes No
Are you prepared to undertake to refrain from smoking whilst working? Yes No
Do you hold a full UK driving license? Yes (Date passed test) No
Do you own a car? Yes  No
Do you have any driving convictions? Yes (Please supply details) No
Are you prepared to drive children in your car? Yes No
Will you accept a job with use of car in day only?  Yes No
Do you suffer from any allergies or Depression? Yes (Please supply details) No
Do you have any illnesses for which you are receiving on-going treatment or medication ? Yes (Please supply details) No
Have you been hospitalised in the last 2 years ? Yes (Please supply details) No
Can you cook? Yes  No
Are you a swimmer? Yes  No
Do you like pets? Yes  No
Do you have allergies to any pets? Yes  No
Have you any criminal convictions? Yes (Please supply details) No
Have you had a police check? Yes No
If you do not have an up-to-date police check would you be willing to have one? Yes No
Do you have a Local Authority check? Yes No
Hobbies And Interests :

 

Your Employment Details

Type of employment required : Nanny Mothers help
Permanent Temporary
Full-time Part-time
Live in Live out
Babysitting Nursery Work
Would you consider a nanny share?  Yes No
If Part Time, Please specificy days and hours :
If Share, please list days, ages and location of current shares :
If Permanent, would you be interesred in short term temporary nanny work?  Yes No
If Full Time, would you accept a part time job and then look for another one?  Yes No
While you are awaiting work, will you undertake occasional cleaning work?  Yes No
Preferred number of children :
Preferred age range :
Preferred location :
Minimum salary expected :
When can you take up employment? 
If live-in, what sort of accommodation are you looking for (please tick): Seperate Own Floor
Wash Own Bathroom
Share Bathroom With Children Share Bathroom With Family
Do you want to live as part of the family?  Yes No
Are you available to work flexible hours?  Yes No
Are you prepared to work with a parent at home?  Yes No
Are you prepared to work with a parent working from home?  Yes No
Will you work at weekends?  Yes No
Will you go on holiday with the family?  Yes No
Are you prepared to do the following (please tick): Cook Iron
Wash Babysit
Light-Housework Heavy-Housework
Do you have any holidays booked within the next six months?  Yes No

 

Education
Senior school attended :
Dates attended : (From) (To)
Qualifications obtained :
       
College / University :
Dates attended : (From) (To)
Qualifications obtained :

 

Employment History
Name and address of current employer :
Telephone number :
Dates employed : (From) (To)
Brief description of duties :
        
Name and address of previous employer :
Telephone number :
Dates employed : (From) (To)
Brief description of duties :
        
Name and address of previous employer :
Telephone number :
Dates employed : (From) (To)
Brief description of duties :

 

Character References
Name :
Address
Telephone number :
Name :
Address
Telephone number :

 

Further Information
Please enter any further information that you think may be of use to prospective employers. This may include duties you do / do not like performing.

 

Clicking on the 'Submit' button declares that the information provided above is correct and signifies your agreement for Nannies Plus LTD to pass on your details to prospective Employers.

 

 

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