Family Surname      

Address

Home Phone Mobile e-mail

 Emergency Contact Details

 Have you had a Nanny before?        Yes        No  

Are you a one-parent family?               Yes        No

C

Name D.O.B. 1st Child 2nd Child 3rd Child 4th Child

hildren’s Details:

Type of Childcare required?

Maternity Nurse              Nanny                  Baby-sitter   

Nursery Nurse                  Au-pair                Other             

Position Offered

Permanent                            Full Time              Live In             

Temporary                          Part Time              Live Out       

Hours required per Week/Month?  

                           Days                          Weekends      

                           Nights                        Variable            

Job Description

Nursery Duties                 Preparing Children’s Meal                   

School Run                       Assist with School Homework       

Additional Information about this Position: 

 

Start Date Required   

All Information is treated in the strictest confidence and according to the Data protection Act.