Client Registration Form

1
Date
2
Full name/s
3
Address
Post Code
4 CONTACT DETAILS
Day Tel Mobile
Eve Tel Email
Preferred method of contact:  Day Tel   Eve Tel   Mobile   Email
5 YOUR FAMILY
Names & Ages of each child:
  Name Age
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6

Do your children have any special needs, dietary requirements or suffer from any allergies?


Childrens social activities and/or educational stipulations (ie. School, Clubs, etc.)?


Do you have any pets (please give details)?
6 YOU & YOUR PARTNER
  You Partner
Occupation
Place of work (ie. London)
Religious preferance (if any)
7 CHILDCARE REQUIREMENTS
Date on which you require Nanny to start work:

Full Time Part Time
Nanny/Mothers help Sole Charge Yes      No
Live-in Live-out
If you ticked 'Live in', please give details of accommodation to be provided:

Nett salary offered per week/month:
Days of work: Average hours of work per week
Annual paid holiday allowance / days off per week:
Would the Nanny be required to do any amount of travelling with you (abroad or in the UK)? Yes      No      Sometimes
Possible requirement of overtime (i.e. babysitting)? Yes      No
Driver essential? Yes      No Will a car be available? Yes      No
If employee uses their own car, will you reimburse for petrol/insurance costs?      Yes      No
Smoker/Non-smoker preferred? Do you employ any domestic help?
Have you employed a Nanny before?      Yes      No
Are you prepared to employ a Nanny who has their own child/ren?      Yes      No
Are their any other adults living at your home, not previously mentioned?      
Where did you hear about us?      other:

8 Please give a rough outline of your expectations from your nanny (i.e. Daily duties, personality and experience):

     



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