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Register with us

If you are interested in finding childcare help, please register with us by filling in the form below. You can also download this form, complete it and send it back to us.

Personal details

		Father	Mother
	First Name

	Surname

	Profession

	Nationality

Contact

	Address
	City/County
	PostCode
	Country
	Tel (Day)
	Tel (Evening)
	Mobile
	E-Mail

More about your family

	Main language spoken at home
	Other languages used
	Religion

	Please tell us about any hobbies or interests:

	Please tell us about any other relevant information such as dietary requirements:

About your children

	Name	Age	Gender	Do they visit nursery/ playgroup/ school/ boarding school? Full or part time?
1
2
3
4
5

Your requirements

	Type of Carer required
	Required from:	d m y
	For how long?
	Preferred Nationality
	Preferred gender
	Required to drive
	Will the carer have use of a car?
	Must be non-smoker?
	Do you have any preferred requirements such as ability to play musical instruments, play certain sports, speak certain languages?

	Please give details of the carer's duties

	Free time per week
	How much are you willing to pay?
	Do you employ other home help?
	Where did you hear about our agency?