Applicant Registration Form

Name*

Address

Address for Correspondence: (if different from above)

Email Address

Home Tel. No.

Mobile No.

Facsimile No.

Preferred Method of Contact

Gender

Nationality

Marital Status

Have you had any health problems or allergies in the last 5 years? If so, please specify:

Do you have any special dietary needs?

Do you have any religious beliefs you would expect an employer to respect? If so please specify:

Please provide the full names and addresses of the schools, colleges and universities you have attended:

Name/Address/Dates 1:

Name/Address/Dates 2:

Name/Address/Dates 3:

Space for extra info:

Qualifications Obtained:

Are you registered/approved by Ofsted?

Do you have a full driver’s license?

Date you passed your driving test:

Is your driving license for a manual, automatic or both?

Is your driving record clean? If not specify the offence(s):

Do you have any criminal convictions? If so please specify:

Do you have an uptodate Police/CRB check?

Please provide the full names and addresses of your previous employers:

Name/Address/Length of Employment/Type of Work Undertaken 1:

Name/Address/Length of Employment/Type of Work Undertaken 2:

Name/Address/Length of Employment/Type of Work Undertaken 3:

Space for extra info:

Type of employment sought (i.e. nurse, nanny, live in/out, full time/part time, mother’s help)

When are you available to start?

Length of contract sought:

Age group(s) would you prefer to care for?

Salary bracket required £(net)

Passport number and expiry date:

If you are coming from overseas do you need and have a valid visa/work permit? If so please give details:

When are you arriving in the UK?

Do you speak any languages other than English? If so please specify:

Are you prepared to work with a single parent?

Can you swim?

Do you have a current First Aid Certificate?

Do you like household animals?

Would you help with housework (within reason)?

Would you help with cooking (within reason)?

What are your hobbies and interests?

Please provide the names and contact details of 2 people we may approach in order to obtain a personal reference:

Referee 1:

Referee 2:

Please provide the name, address and telephone number of your next of kin:

Do you have any friends/relatives in the UK?

How did you hear about us?

If you are happy that you have filled in the correct information, click below to submit your form.

CLICK HERE TO APPLY >

Please Supply:

• Copies of any written references.
• A copy medical certificate as to your current health.
• A current photograph of yourself.
• Copies of any relevant certificates (eg. First Aid Certificates, Swimming Certificates).
• A copy of your driver’s licence.
• A copy of your police clearance certificate (CRB).
• A copy of your passport including a copy of your visa/work permit.
• A copy of your Ofsted certificate.

You should bring the originals of all the above to your interview.

All data you submit is protected by the Data Protection Act and will not be given or sold to any third party.