Home
Parents
Nannies
We Love...
Contact Us
Parent Application Form
Please fill out the below form to find your perfect childcarer.
Title
Family Name
First Name
Address 1
Address 2
Address 3
Postcode
Home Tel. Number
Office Tel. Number
Fax Number
Email
Mother's Occupation
Father's Occupation
Nationality
Nationality
Age
Age
Child's Name
DOB
Gender
Please Select
Male
Female
Child's Name
DOB
Gender
Please Select
Male
Female
Child's Name
DOB
Gender
Please Select
Male
Female
Child's Name
DOB
Gender
Please Select
Male
Female
Is there any physically/mentally disadvantaged person in the household?
No
Yes
Do any of your children have special needs or specific learning difficulties?
No
Yes
Help Required
Please Select
Mother's Help
Nanny
Housekeeper
Maternity Nurse
Hours of work required?
Days Required
Qualification Required
Yes
No
Live in
Yes
No
Will the applicant have sole charge of children
for long periods
Yes
No
Is there a new baby expected? If so, when?
Would the applicant be expected to deal with him/her?
Yes
No
Please give details of any household staff
currently employed
Do you have pets?
Yes
No
If yes please give details...
What are the hobbies/interests within the family?
What type of home do you have?
House
Flat
Farm
Other
Do you have any special facilities (Tennis Court, Swimming Pool, etc)?
Yes
No
What accommodation is available if live-in help required?
Own Room
Own Bathroom
Shared Room
Shared Bathroom
Own TV
Self Contained Room
Other
Would you require a car driver?
Yes
No
Is there a car available for the nanny?
Yes - Sole Use
Occasional Use
No
What duties will be required?
Childcare
Yes
No
Children's Cooking
Yes
No
Family Cooking
Yes
No
Driving Children
Yes
No
Light Housework
Yes
No
Shopping
Yes
No
Children's Ironing
Yes
No
Family Ironing
Yes
No
Salary Offered
Preferred Start Date
Duration of Employment
When you are away on holiday/business will the nanny be expected to travel with with you?
Yes
No
Have you previously employed anyone to help with your children?
Yes
No
If 'Yes' how long were they employed by you?
Are you happy for your telephone number to be given to prospective applicants?
Yes
No
Are you happy for Violet Elizabeth Nannies to advertise this position on your behalf?
Yes
No
How did you hear of Violet Elizabeth Nannies?
Yellow Pages
Thomson
Friend
Poster
Internet
Other
Other - please specify:
Please give name and address of an unrelated person who we may contact to obtain a family reference:
In what capacity do you know this person?
Friend
Employer
Other
Other - please specify:
Enter the security code exactly as it appears.
