Title * —Please choose an option—MrMrsMissMs
First name *
Surname *
Email *
Mobile *
House/Flat number *
Address *
City/Town *
Postcode *
Country *
Nationality *
Are there any health conditions we need to be aware of? —Please choose an option—YesNo
If yes, please provide details:
Do you smoke? —Please choose an option—YesNo
Do you have any children? —Please choose an option—YesNo
When are you free to start?
How many nights a week can you work? —Please choose an option—1234567
Is there anywhere in UK you are not prepared to work/travel? (Expenses will be reimbursed) —Please choose an option—YesNo
How many children are you happy to look after? —Please choose an option—12345
Do you hold a current valid UK working visa? —Please choose an option—YesNo
Do you have any experience of caring for children with Special Needs? —Please choose an option—YesNo
Would you work with Special Needs children? —Please choose an option—YesNo
If yes, are there limitations? Please provide details:
Upload your CV - Allowed file extensions are .doc, .docx, or .pdf - Limit 3Mb
I certify that this information that I have supplied is true and correct and I confirm that I accept your terms and conditions of business. I also realise that any information given to me about potential employers or other applicants is highly confidential. I agree not to divulge any such information to anyone. Should I obtain a position through your Agency directly or indirectly or be re-employed at any stage I will notify you immediately. It is understood and agreed that any misrepresentation by me on this application form will be sufficient cause for cancellation of this application and/or termination from the Agency's service if I have been employed. I give the Agency the right to investigate all references and to secure additional information about me if job related. I hereby release from liability the Agency and its representatives for seeking such information and all other persons, corporations or organisations for furnishing such information.
Note that this form may be shown to a prospective client.
We are an Equal Opportunity Employer. We do not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by law.