Print this form and return to Nanny Seekers at the above address
NAME:
ADDRESS:
TELEPHONE NUMBER (HOME): (WORK):
E-MAIL ADDRESS:
HUSBAND'S OCCUPATION:
WIFE'S OCCUPATION:
DETAILS OF CHILDREN:
| Name | Age | Sex |
ACCOMMODATION:
If the position is live-in, please give brief details of the accommodation
that will be provided:
DO YOU REQUIRE A:
| Qualified/Experienced Nanny | YES / | NO |
| Au Pair | YES / | NO |
| Mother's Help | YES / | NO |
| Babysitter | YES / | NO |
| Do you have pets? | YES / | NO |
| Do you require a non-smoker? | YES / | NO |
| Do you require a driver? | YES / | NO |
| Will a car be provided for the nanny to use? | YES / | NO |
Please give a brief outline of the duties you wish your nanny to perform:
Is the position permanent or temporary?
Commencement date:
Salary offered:
Please acknowledge your registration by signing and dating below:
Signature: Date: