NANNY REGISTRATION
PERSONAL DETAILS
Name:
Telephone Home:
Telephone Mobile:
E-Mail:
Nationality:
Date of Birth:
Present Address:
Marital Status:
Any Children:
If yes, ages:
Can you drive?:
Can you swim?:
Do you smoke?:
Hobbies and interest:
Are you generally healthy:
Have you had any major illness/operation:
If so, please give detail:
Do you take any meditation:
If so, please give detail:
Do you have any sight or hearing problem:
If so, please specify:
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
THE TYPE OF WORK YOU ARE INTERESTED IN
Type of work:
Start Date:
If temporary, until what date:
Weekly salary required:
What age of children would you prefer:
How many children would you prefer to look after:
Temporary
Permanent
New born
6-12 months
12-24 months
2-3 years
3-6 years
6 years and older
CHILD CARE QUALIFICATION
Are you qualified nanny:
Which qualification do you hold:
How many years experience do you have:
Have you worked in other childcare fields:
If yes, where and how long:
No
Yes
No
Yes
EMPLOYEMENT HISTORY
Name of family:
Telephone:
Address:
Date start:
Date finish:
Age of chidren you care (from the date start):
Reason for leaving:
Can we contact for references:
No
Yes
Name of family:
Telephone:
Address:
Date start:
Date finish:
Age of chidren you care (from the date start):
Reason for leaving:
Can we contact for references:
No
Yes
Name of family:
Telephone:
Address:
Date start:
Date finish:
Age of chidren you care (from the date start):
Reason for leaving:
Can we contact for references:
No
Yes
OTHER WORK EXPERIENCE
Company:
Position:
Date start:
Date finish:
Telephone:
Person to contact:
Company:
Position:
Date start:
Date finish:
Telephone:
Person to contact:
Company:
Position:
Date start:
Date finish:
Telephone:
Person to contact: