Tiny Delights | Nanny Agency > Nanny Registration
NANNY REGISTRATION
* NAME
* EMAIL
ADDRESS
DATE OF BIRTH
HOME PHONE
MOBILE
NATIONALITY
IS ENGLISH YOUR FIRST LANGUAGE? Yes     No
DRIVERS LICENCE Yes     No
NUMBER 
    STATE 
OWN TRANSPORT Yes     No
MAKE/YEAR/REGO
DRIVING CONVICTIONS Yes     No
IF YES, GIVE DETAILS
SMOKER Yes     No
ALLERGIES
SPECIAL DIETARY NEEDS
ARE YOU ON ANY MEDICATION?
DO YOU HAVE ANY HEALTH PROBLEMS?
DO YOU HAVE ANY CRIMINAL CONVICTIONS? Yes     No
IF YES GIVE DETAILS
HAVE YOU OBTAINED A BLUE CARD?
LEVEL OF EDUCATION REACHED
NAME OF COLLEGE/UNIVERSITY
OTHER CERTIFICATES
FIRST AID CPR
EXPIRY
OTHER LANGUAGES
SKILLS/TALENTS
INTERESTS/HOBBIES
ARE YOU WILLING TO:
COOK
IRON
DO LIGHT HOUSEWORK
DO WASHING
RUN ERRANDS
DRIVE CHILDREN
IS THERE ANYTHING YOU ARE NOT WILLING TO DO?
PLEASE BRIEFLY LIST YOUR CHILDCARE EXPERIENCE INCLUDING DATES, AGES OF CHILDREN & DUTIES PERFORMED
WHAT POSITION/S ARE YOU APPLYING FOR?
LIVE-IN NANNY CASUAL DAY NANNY (6AM-6PM) AFTER SCHOOL CARER OVERNIGHT NANNY
LIVE-OUT NANNY SHARE NANNY MOTHERS HELPER HOLIDAY NANNY
BABYSITTER (FROM 6PM) NANNY/HOUSE KEEPER TEMPORARY NANNY NANNY FOR SPECIAL EVENT
HAVE YOU HAD EXPERIENCE WITH:
NEWBORNS Yes     No
INFANTS Yes     No
TODDLERS Yes     No
TEENAGERS Yes     No
SCHOOL AGE Yes     No
SPECIAL NEEDS Yes     No
LARGE FAMILIES Yes     No
MULTIPLE BIRTHS Yes     No
EARLIEST START DATE
WHAT IS YOUR PREFERRED AGE GROUP?
DO YOU HAVE ANY EXPERIENCE WITH SPECIAL NEEDS? IF SO PLEASE GIVE DETAILS
PLEASE FILL IN THE TIMES AND DAYS YOU ARE AVAILABLE
  MON TUE WED THU FRI SAT SUN
AM
PM
ARE YOU AVAILABLE FOR OVERNIGHT STAYS? Yes     No
PLEASE GIVE ADDITIONAL DETAILS OF AVAILABILITY


IN CASE OF AN EMERGENCY PLEASE FILL IN THE DETAILS OF YOUR NEXT OF KIN
NAME
RELATIONSHIP
ADDRESS
MOBILE
HOME


PLEASE GIVE THE INFORMATION OF YOUR REFEREES
REFEREE 1
FIRST NAME
SURNAME
CONTACT NUMBER
COMPANY
RELATIONSHIP TO YOU
DATES OF EMPLOYMENT Month        Year 

REFEREE 2
FIRST NAME
SURNAME
CONTACT NUMBER
COMPANY
RELATIONSHIP TO YOU
DATES OF EMPLOYMENT Month        Year 

REFEREE 3
FIRST NAME
SURNAME
CONTACT NUMBER
COMPANY
RELATIONSHIP TO YOU
DATES OF EMPLOYMENT Month        Year 


HOW DID YOU HEAR ABOUT US?
 I have read, agreed to and fully understand the Terms and Conditions as set out by Tiny Delights Nanny Agency.