Staff Enrolment Registration form

Personal Details Name: *
Address:
Data of Birth:
Married/Living with Partner/Single:
Dependants:
Nationality:
Do you smoke? Yes/No If yes, how many per day?
Are you fit and healthy?:
What are your hobbies?
Mobile No
Home Tel. No
Email
Religion
Year obtained driving licence
Is your driving licence clean?
Do you own a car?
What type of car insurance?
Do you have any allergies?

School and Training Do you have an up to date 1st Aid Cerificate
Which secondary school did you attend?
College or other qualifications

Details of Previous Employment Please list the names of your previous 3 employers starting with the most recent one, giving dates of employment and, where applicable, the ages of the children when you started:

Type of work required

Permanent
Part Time
Temporary

Nanny duties only
Nanny duties and light house work
Maternity Nurse / Doula / Night Nanny
Baby sitting (up to nights per week)

What is your present salary: net/gross

Residential
No of days/hours per week:

Available from: to

Sole charge in parents absence
Washing/ironing apart from children’s clothes
Weekend work/BBS or crèche
Would you travel with the family?
When do you wish to start a new job?

What salary are you looking for: net/gross

Other information Is there any other information you would like to add which you think will help us find the right job for you?

References Please give the names of two referees with addresses and telephone numbers

Please list other agencies you are registered with:

Additional information Do you have a current CRB?
If yes please give date it runs out

Do you have Personal Public Liability Insurance?
If yes with which company?

Do you have a Police Record?
If yes please supply details

I declare the above to be true and I am happy for the details to be passed on to prospective employers.

Additionally to the form please send us your CV to info@wealdennannies.co.uk