PERSONAL DETAILS
Name:  
Address:  Post Code:  
Tel. No. (Home) Tel. No. (Work)  
Tel. No. (Mobile) Fax No.  
Email Address:
 
Religion:    

FAMILY DETAILS
Father’s occupation:    
Mother’s occupation:    
Does anybody work from home? 
 No Yes 		If yes, please give details:
  
Are there any other employee’s working at the house?
No Yes  
 If yes, please give details:
  

CHILDREN
First Child
Boy  Girl
Name:
Age:
Does your child attend Playgroup / Nursery / School:
Any medical problems / allergies / special requirements:
Second Child
Boy  Girl
Name:
Age:
Does your child attend Playgroup / Nursery / School:
Any medical problems / allergies / special requirements:
Third Child
Boy  Girl
Name:
Age:
Does your child attend Playgroup / Nursery / School:
Any medical problems / allergies / special requirements:
   
If more children, please use separate paper to provide details:
Are you expecting another baby?
No Yes  		 If yes, what is the anticipated date:  
Do you have any pets:
 No Yes 		If yes, please detail:
 
Have you employed a Nanny / Mother’s Help before? 
No Yes  		 If Yes, please note dates of employment of previous employee and reason for leaving:
  

TYPE OF EMPLOYEE REQUIRED



Live in
Live out

Permanent
Temporary

Full time
Part time

Please indicate which days:

Monday
Tuesday
Wednesday
Thursday
Friday

 

 

Start Time:

Finishing:

 
Starting date: (If temporary, finishing date)  
Is it a Nanny Share?
 No Yes    
Would you consider an employee who brought their own child to work?
 No Yes    
Is a driver essential?
 No Yes    
Is a swimmer essential?
 No Yes    
Would the employee carry out Nursery duties?  
 No Yes    
Would the employee carry out light household duties?
 No Yes    
Would the employee be required to care for family pets?
 No Yes    
Is there a car provided?
 No Yes  
 If yes, is it:
manual  Automatic
Would the employee use the car  
 daily (work hours)       Weekend     use (personal)		  
Would the position involve travelling with the family?
Yes  No 		If yes, please provide details:

 

LIVE IN POSTIONS
Please provide detailed information on accommodation provided including if friends are welcome:  
Please use space below to provide any additional information including preferred days and times for interviews with candidates:  

CONFIRMATION
How did you hear about Nanny Smart?  
I confirm that the above information is correct and I have read and accept your terms and conditions:
 No Yes