Nanny Form

Family Forms

Au Pair Forms

UK Families

Nanny Agency Fee

PERSONAL DETAILS
Surname:
Christian Name (s):
Address:
Town		Post Code
Country	-select- Algeria Andorra Argentina Austrialia Austria Bahrain Belgium Brazil Brunei Bulgaria Cameroun Canada China Croatia Cyprus Czech Repulic Denmark Egypt Estonia Finland France Germany Gibraltar Greece Hongkong Hungary Iceland India Indonesia Iran Iraq Ireland Isreal Italy Japan Jordan Kuwait Lithuania Luxembourg Malaysia Malta Mexico Morocco Netherlands New Zealand Nigeria Norway Pakistan Philipines Poland Portugal Qatar Romania Russia Saudi Arabia Singapore Slovenia Slovak Republic South Africa Spain Sri Lanka Sudan Sweden Switzerland Syria Taiwan Thailand Tunisia Turkey United Arab Emirates United Kingdom United States Vietnam
Telephone number (plus area code)
Fax no (plus area code)
Email
Nationality
Height (in cm)		Weight
Date and place of birth		Age
Passport / Identity Number
What do you wish to be?	Au Pair    Mother's Help    Nanny
In which country do you wish to be placed:	Austria Belgium England Finland France Germany Greece Ireland Italy Scotland Spain Switzerland Turkey Wales Other
Au Pair Care Programme (USA): (Brochures and application will be sent to you by post)			Yes No
When do you wish to commence employment?
Length of employment (USA - 1 year stay only)
Do you require a live in or live out position (Nannies / Mother's Help, UK positions only)
Salary / Pocket Money required
Please specify destination of your choice:	1st Choice
	2nd Choice
	3rd Choice
Do you prefer town or countryside?
EDUCATION / EMPLOYMENT DETAILS
Last School / College / University attended
Examinations / Qualifications obtained
English level (Not applicable to British Nationals)		Basic  Fair  Good
How long have you studied English?
Other languages spoken 1	Basic  Fair  Good
Other languages spoken 2	Basic  Fair  Good
Other languages spoken 3	Basic  Fair  Good
Current occupation
Length of notice to be given
Previous occupation
Do you have any First Aid or other certificates? e.g. Lifesaving, Certificates of Merit, Swimming, Music, Sports etc.
Do you have any formal childcare qualifications?		Yes No
If yes, which qualifications do you have?
EXPERIENCE WITH CHILD CARE  AND HOUSEWORK
Childcare: State ages of children you have cared for and please submit references
Housework
Cooking
ADDITIONAL INFORMATION
Are you in good health?
Do you have any allergies
Do you have a criminal record?
Do you eat everything?
Will you accept a family of any religion / race or ethnic origin?
Do you smoke?
How many a day?
Would you agree not to smoke in the family's home?
Which sports do you play?
Do you like animals?
Do you have a driving licence?
Date test passed
Would you drive abroad?
Give details concerning your hobbies and interests and any further information which will enable us to find a suitable placement for you:
Declaration I fully understand the Agency's conditions and accept that the fee payable (for placements in Europe excluding UK) is only a finders fee. I agree to abide by these conditions. furthermore, all the details given by me on this application form are correct. Yes No

Additional items to send after filling this form

Please send all the following items by post (not applicable for the Au Pair Care Programme)

1. 6 smiling passport photographs with your name on reverse.
2. At least 2 large photographs showing you with children / babies.
3. A medical certificate stating you are fit to work with children.
4. An autobiographical letter written in the language of the country where you wish to be placed.
5. At least 2 child-care references from teachers / employers etc.
6. All these items must accompany your completed application form.
7. If you have requested a Nanny placement, copy of NNEB or similar certificates, should accompany your application form.

E-mail:aupair@1stclassnannies.co.uk