CLIENT REGISTRATION FORM
Personal Details
Name
Address
Telephone
Day
Mobile
Evening
Email Address
Best time/ way to contact you
Details of your children
Occupation/ place of work of each parent
Details of any pets
Position
Please select the details of the vacancy you have
Nanny
Parents help
Nanny/ housekeeper
Au Pair
Full or part time?
Full time
Part time
If part time which
days
/ times?
Live in/ live out
Live in
Live out
If live in please give details of accommodation
Permanent/ temporary
Permanent
Temporary
Sole charge/ shared
Sole charge
Shared
Will there be a possibility of overtime/ babysitting?
Yes
No
Start date
Brief outline of job description to include duties/ experience/ qualifications/ personally required
Net salary offered per week/ month
No. of paid days holiday per year
Will carer be required to travel with family?
Yes
No
Does nanny need to be a driver?
Yes
No
Will a car be available?
Yes
No
If nanny uses own car, will you reimburse
Petrol
Insurance
Smoker
Non smoker
Would you consider a nanny with her own child?
Yes
No
Declaration
I declare all information to be true and accurate. I agree to the terms and conditions of Bluebell Nanny Agency
Full name
Dated
Nannies Register
HERE
