Nanny Registration


Your personal details:
First name:
Surname:
Maiden name:
House/Flat number:
Address line 1:
Address line 2:
Town/City:
County:
Post code:
Marital status:
Dependent children:
Date of birth:	dd/mm/yy
Place of birth:
Nationality:
Main and other languages spoken:
Home telephone No.:
Mobile telephone No.:
Work telephone No.:
Your email address:

Personal information:
Do you hold a valid 10-year passport?
Country of issue:
National Insurance number:

Do you hold a full driving licence?
Any penalties?
Licence number:
Make and model of car:
Are you happy to use your car for work?
Year test passed:	yyyy

Have you ever had a criminal record?
Do you hold an enhanced CRB?
Disclosure date:	dd/mm/yy
Disclosure number:
Do you smoke?	All our childcare positions are Non smoking and it is unlikely we will be able to place a smoker in employment with children.
Describe your health:
Have you got any disabilities?
Are you taking any medication?
Any dietary requirements or allergies?
Do you hold a valid first aid certificate?
Can you swim?
Cooking skills?
Do you like animals?
Are there any animals you are not comfortable with?
Positions sought: (Tick all that apply)	Part-time: Full-time: Flexi: Daily: Live-in: Weekends: UK: Overseas: Temporary: Permanent: Nanny: Mothers Help: Maternity nurse: Doula: Nanny share: Fathers Help: Nursery nurse: Special events: Night nanny: Governess: Emergency nanny: Sole charge: Au pair: Maternity nanny: Housekeeper: Special needs: Behavioural difficulties: Babysitting:
Preferred number of children?
Preferred age range?
Expected salary (please state)	£
Preferred location of work?	within radius
What date are you available to start work?	dd/mm/yy

Duties desired:
(Tick all that apply)	Nursery duties only: Light Housework: Cleaning: Driving: Pet care : Cooking: Shopping: Ironing:
Charge: (Tick all that apply)	Sole charge: Shared charge: Both:

Education and Training:
Are you Ofsted registered?
Ofsted registration no.:
If not Ofsted registered, are you willing to do so?
Qualifications:
	NNEB: NORLAND: BTEC: CACHE: NVQ: OTHER:
Additional information:

Experience:
	Special needs: Twins/Multiple: Newborns: Behavioural Difficulties:
Additional information:
Employment history:
Position 1:
Job title:
Dates of employment	From: To: dd/mm/yy
Employer's name:
Address
Telephone number:
Email address:
Age of children at start of employment:
Can we reference check?
Position 2:
Job title:
Dates of employment	From: To: dd/mm/yy
Employer's name:
Address
Telephone number:
Email address:
Age of children at start of employment:
Can we reference check?
Position 3:
Job title:
Dates of employment	From: To: dd/mm/yy
Employer's name:
Address
Telephone number:
Email address:
Age of children at start of employment:
Can we reference check?
Position 4:
Job title:
Dates of employment	From: To: dd/mm/yy
Employer's name:
Address
Telephone number:
Email address:
Age of children at start of employment:
Can we reference check?
Gaps:
Please explain any gaps in your employment history:
Referees:
Referee 1:
Name:
Relationship:
Address
Telephone:
Email:
Referee 2:
Name:
Relationship:
Address
Telephone:
Email:
Referee 3:
Name:
Relationship:
Address
Telephone:
Email:
Personal Statement:

Send us your CV & Photo:
CV:	Location on your PC. Your file uploads at the same time as your registration Max file size = 1mb. Only Word doc and docx files are accepted
Recent photo:	Location on your PC. Your photo will upload at the same time as your registration Max Size = 1mb. Only jpeg, jpg, bmp, gif and png files are accepted
Further Information:
Are you registered with any other agencies?
If Yes, please state:
How did you hear about the Parent & Child Nanny Agency?
I accept the terms and conditions	Terms and conditions

	Before you submit this registration please check through carefully as some of the information in this registration will be used to create your nanny profile. copyright@2009 - The Parent & Child Nanny Agency