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Title Mrs Miss Ms Mr Sheikh Lady Dr Professor Other
First Name *
Surname *
Address 1 *
Address 2
City/Town *
County *
Postcode/Zip *
Country * Albania Algeria Angola Argentina Armenia Australia Austria Azerbaijan Bahrain Bangladesh Barbados Belarus Belgium Bolivia Botswana Brazil Brunei Bulgaria Burkina Faso Cambodia Cameroon Canada Chile China Colombia Costa Rica Croatia Cuba Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Fiji Finland France French Polynesia Gambia Georgia Germany Ghana Greece Guam Guatemala Guyana Hong Kong Hungary Iceland India Indonesia Iran Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Libya Lithuania Luxemburg Macau Macedonia Madagascar Malawi Malaysia Malta Mauritania Mauritius Mexico Moldova Mongolia Morocco Mozambique Namibia Nepal Netherlands New Zealand Nigeria Norway Oman Pakistan Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Republic of Ireland Reunion Romania Russia Rwanda Samoa Saudi Arabia Senegal Singapore Slovakia Slovenia South Africa Spain Sri Lanka Sudan Swaziland Sweden Switzerland Taiwan Tanzania Thailand Trinidad and Tobago Tunisia Turkey Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Venezuala Vietnam Yemen Yugoslavia Zambia Zimbabwe
Contact Number *
Email *
Mother's Occupation *
Father's Occupation *
Nationality/Language Spoken at home *
Position Type * Nanny Maternity Nurse Tutor Other
If Other - Please Provide Details
Daily/Live-in * Daily Live-in Either Daily/Live-in Overseas
Full/Part-Time * Full-Time Part-Time Either
Perm/Temp * Permanent Temporary Either
If Temporary - Please Give Details
Start Date *
Salary Bracket * £350-£450 £450-£550 £550-£650 £650-£800 £800+
Preferred Age Range * 23-26yrs 27-33yrs 34-44yrs 45yrs+
Child 1 Name
Child 1 Age
Child 1 Gender Male Female
Child 2 Name
Child 2 Age
Child 2 Gender Male Female
Child 3 Name
Child 3 Age
Child 3 Gender Male Female
Child 4 Name
Child 4 Age
Child 4 Gender Male Female
Child 5 Name
Child 5 Age
Child 5 Gender Male Female
Child 6 Name
Child 6 Age
Child 6 Gender Male Female
Baby Date for New Baby
Additional Information
Type of Residence * House Estate Apartment Villa Palace
Formal/Informal Residence * Formal Informal
Do you Require a Driver? * Yes No Helpful but not Essential
Car Provided? * No Yes
Any Other Household Staff? Yes No
Sole Charge or Shared Care Position Sole Shared
Days/Hours Required
Accommodation Details
How Did you Hear About us? Search Engine Magazine Referral Other
If Other - Please provide details
I have read and accept the Terms and Conditions
Once you have submitted the form, a representative from the agency will contact you to discuss the finer points of your vacancy. Please ensure your telephone numbers and email address are correct prior to submitting the form.