Family Registration Form
(for the placement of a Nanny/Mothers Help)

Family Details:

* Family Name:
* Address:
* Location:
* Postcode:
* Daytime Tel No:
* Evening Tel No:
Email:
Language(s) Spoken at Home:
Family Interests/ Activities/ Special Diets:
Mother's Details:
Name:
Nationality:
Occupation:
Religion:
Father's Details:
.
Name:
Nationality:
Occupation:
Religion:

Children's Details:

		Name:		Gender:(M/F)		Age:
Child 1:				M F		< 3 months 3-6 months 6-12 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years Teenager
Child 2:				M F		< 3 months 3-6 months 6-12 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years Teenager
Child 3:				M F		< 3 months 3-6 months 6-12 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years Teenager
Child 4:				M F		< 3 months 3-6 months 6-12 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years Teenager
Child 5:				M F		< 3 months 3-6 months 6-12 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years Teenager
Is a New Baby Expected?				N Y
When?

Property and Location Details:

Type of Property:	House Flat
No. of Bedrooms:
No. of Bathrooms:
Any pets? (provide details):
Household staff? (provide details):
Nearest Tube Station:
Nearest Railway Station:

Nanny Details:

Is this your first Nanny?:	No Yes
.
* Proposed Weekly Salary:
.
Free Time:
.
* Nanny Type:	Permanent (5 days/week) Part-Time (4 days/week) Part-Time (3 days/week) Part-Time (1-2 days/week) Temporary (week on week) Mothers Help Other (please specify)
.
If 'Other' please specify:
.
* Live-in/Out?:	Live-out Live-in
.
Hours/Day:	8 hours 7-8 hours 6-7 hours 5-6 hours 4-5 hours Under 4 Other (please specify)
.
If 'Other' please specify:
.
Free Time:	Weekends Saturday + 1 Weekday Sunday + 1 Weekday 2 Weekdays Other (please specify)
.
If 'Other' please specify:
.
* A car driver is:	Unnecessary Preferable Essential
.
A non-smoker is:	Preferable Essential Unnecessary
.
Is the Nanny expected to carry out the following duties?
.
Babysit	No Yes
.
If yes, number of evenings per week?	0 1 2
.
* Take Sole Charge	No Yes    (Normally carried out by Nanny)
.
Housework	Yes No    (Not normally carried out by Nanny)
.
Cooking	No Yes    (Not normally carried out by Nanny other than for children under her charge)
.
Ironing	No Yes    (Not normally carried out by Nanny other than for children under her charge)
.
* When would you like the Nanny to start?
.
* For what period?	12 months+ 5-12 months under 5 months
.
Would you employ a male Nanny?	No Yes
.
Will the Nanny have her own room?	Yes No
.
Will the Nanny have her own bathroom?	No Yes
.
Will the Nanny have her own TV?	Yes No
.
Would you employ a Nanny of any nationality?	No Yes
Approx. Daily Schedule (am)
Approx. Daily Schedule (pm)
Any special duties or requirements?

JOBS IN DEMAND LIMITED WILL USE THE INFORMATION YOU PROVIDE FOR THE PURPOSES OF MATCHING YOU WITH A SUITABLE NANNY/MOTHERS HELP. TO THIS END, WE MAY DISCLOSE THIS INFORMATION TO OUR AGENTS OR POTENTIAL NANNIES/MOTHERS HELPS WHO IN OUR OPINION MEET YOUR REQUIREMENTS AND YOU HAVE CONSENTED TO US DISCLOSING THIS INFORMATION.

BY SUBMITTING THIS FORM TO JOBS IN DEMAND LIMITED YOU CONSENT TO IT PROCESSING SENSITIVE PERSONAL DATA ABOUT YOU WHERE THIS IS NECESSARY FOR THE PURPOSES DESCRIBED ABOVE, FOR EXAMPLE HEALTH, NATIONALITY/RACE AND RELIGION.

YOU HAVE A RIGHT TO ASK FOR A COPY OF THE INFORMATION HELD ABOUT YOU BY US (FOR WHICH A SMALL FEE MAY BE CHARGED) AND TO CORRECT ANY INACCURACIES IN YOUR INFORMATION.

Note: By submitting this registration form you confirm that you have read and understood the Terms & Conditions of business and agree to be bound by them in all dealings with Jobs In Demand Limited.