Name*

Address

Nationality

Date of Birth

MarriedSingleDivorcedSeparatedWindowed

Home tel no

Mobile

E-mail

Next of Kin or Permanent Address if different from above

Next of Kin telephone no (incl. code)

Nature of work required, ie:
NannyMother's HelpMaternity Nurse

Do you need to give notice, if yes how long?

Available from (Date)

Available to (Date)

Live inLive out

Which Days? (Please select the days you are available)
MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Net Salary Required £
per week

Present/Last Salary £
per week

Where do you want to work?
Central LondonOuter LondonOverseas

Do you have a valid Passport?

Do you have a Work Permit/Working Holiday Visa for the UK?

Passport No

Do you speak any other languages?

Fluent?

Conversational?

Do you Drive? Manual or automatic.

Own a Car?

Do you have any driving convictions?

Do you Smoke?

Would you take a Non-Smoking position?

Please tick the relevant boxes
Do you like animalsSkiSwim

Can you Cook?
For adults?For Children?

Will you Iron?
For adults?For Children?

Are you prepared to do Light Housekeeping Duties?

Are you experienced with the following
Babies Under 3 Months?Toddlers?School Age Children (5-16)?

Can you Change Nappies?

Can you Prepare Feeds?

If not, are you prepared to learn?

How many children would you prefer to care for?

Are you prepared to travel with the family?

What age children do you PREFER?

Do you have any children of your own? If yes please specify age.

Number of brothers and sisters and ages

Are you in good health? If not, give appropriate details

Do you have a valid police check?

Have you ever been in trouble with the Police? If yes, give details

Licenced by the Department of Employment. Licence No SE(A)568

DETAILS OF SCHOOLS AND COLLEGES ATTENDED

University or Colleges Attended

Address

Dates

Qualifications & Certificates

PREVIOUS WORK EXPERIENCE - WHETHER OR NOT IT IS APPLICABLE TO CHILDCARE

Present position

Name, Address & Telephone No of Previous Employer

Dates Month/Year

Position Held Daily/Live In

Ages of Children at Start

Salary

Reason for Leaving

Please provide as much information as possible.

Does your present employer know you are leaving?.

Position 2

Name, Address & Telephone No of Previous Employer

Dates Month/Year

Position Held Daily/Live In

Ages of Children at Start

Salary

Reason for Leaving

Please provide as much information as possible.

Position 3

Name, Address & Telephone No of Previous Employer

Dates Month/Year

Position Held Daily/Live In

Ages of Children at Start

Salary

Reason for Leaving

Please provide as much information as possible.

Position 4

Name, Address & Telephone No of Previous Employer

Dates Month/Year

Position Held Daily/Live In

Ages of Children at Start

Salary

Reason for Leaving

Please provide as much information as possible.

Position 5.

Name, Address & Telephone No of Previous Employer

Dates Month/Year

Position Held Daily/Live In

Ages of Children at Start

Salary

Reason for Leaving

Please provide as much information as possible.

We require details on all previous employers, whether childcare related or not. All references will be checked with the exception of present employers if notice has not been given. We cannot accept references from relatives, but character references are useful. Full addresses and telephone numbers are, therefore, essential.
Please upload the following documents, one photograph, references and scans of any childcare certificates. Please give details of all work experience including non-child related positions for all time starting with your first position.

.

Full name

Today's Date

How did you hear of us?

Name, Address and Telephone Number of Emergency Contact

Please upload your DBS here.

Please upload a photo ID here. (Drivers licence/passport and visa if relevant)

Please upload your First Aid Certificate here.

Please upload scans of any qualifications.

Please upload scans of any employment references.

Please upload a recent photo.

The work for which you are applying involves access to children. It is therefore exempt from the Rehabilitation of Offenders
Act 1974 and you are obliged to disclose all pending prosecutions or convictions that you may have. No convictions will be
considered “spent”.

“I certify that this information is true and correct. I consent to my personal data being included on a computerised database and to its
use in order to secure me employment. I consent to my CV being forwarded to clients via electronic mail and I understand the risk
of my CV being unintentionally altered during this process. I consent to references being passed on to potential employers. I also
realise that any information given to me about potential employers or another applicant is highly confidential, and I agree not to
divulge any such information to anyone, without authority from The Nanny Service. Should I obtain a position
through your Agency directly or indirectly or be re-employed at any stage, I will notify you immediately and notify the employer
concerned that the Agency’s fee will be applicable on all occasions.”

I agree with the terms of this application.