Client Registration

Please complete the form below in as much detail as possible – the more information we have about you, the easier it is for us to meet your needs.

If you prefer, you could contact us on 020 7228 2811 and we will be happy to speak to you.

Contact details

Full Name *

Email *

Contact phone*

Address

Address Line 2

City

Postcode

Household Details

Age & gender of children

Parent 1 profession

Parent 2 profession

Household description

Other staff employed

Do you have pets?
 Yes No

If yes, please give details

Type of Staff and Job Description

Type of staff required
 Nanny Mother's Help Maternity Nurse Nanny / Housekeeper Carer Other

If other, please specify

Please state the post offered
 Daily Residential Either

Please state the type of contract offered
 Temporary Permanent Both

Please state ideal start date

Hours and days required*

Duties carried out?

Is a car driver required for the position?
 No Preferred Essential

Is there use of a car?
 No On duty only Sole use of employee

Will candidate be expected to travel?
 No Yes

If yes please give details

Is accomodation provided?
 Yes No

If yes please give details

Salary (£ net per week)

How did you hear about us?

I confirm that the information given above is accurate.
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I have read and agree to your terms and conditions (see link below)
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