Eden Nannies

Client Registration Form

Please read our Fee details before completing this form. Fee Details >>

Due to the size of this registration form, it is advised that you have ALL information available before filling it in. Please answer ALL questions as best as you can. If you wish, you may contact Eden Nannies & Maternity direct and request that we either fax or post you an application pack. We also have a PDF version of this registration form, which you can download here, print out and fill in, in your own time.

Please provide a valid email address as we may not be able to fully process your Registration form without one and may also result in delays or rejection. Please note that we have now placed the option for Nursery Nurse positions

* denotes a required item

Personal Details:
Fee Details: *	Tick the box if you have read our 'Fee' details
Full Name: *
Full Postal Address: *
Home Phone: *		Work Phone:
Fax No.:		Mobile No.:
E-mail: *
Marital Status:		Nationality:
No. of resident adults:
		Boys ages:	Girls ages:
No. of children:
		Please separate each age with a coma.
Baby due date:
Husbands Occupation:		Wifes Occupation:
Description of house:		Second house:
Other Staff:
Household Animals:

Requirements:
I require a	Contract type: Permanent Temporary
Further Details: Box provided for extra details eg: Days & Hours etc.
	Sole Charge: Shared Charge: Both:
If temporary, duration of post:		Driving details:
Job commencement date:		Smoking details:
Age preferred:	Min Max Flexible
Experience:	2 Years min: New N.N.E.B.:
Personality:	Outgoing: Quiet: Sporty: Swimmer:

Duties:
Nursery duties only: Family Shopping: School Runs:
Please state any special dietry requirements (Vegetarian, Kosher) and any other duties not listed above:

Employment Details:
Accommodation Offered:		To select multiple items, please hold down the Ctrl key on your keyboard and click on the required items.
Pets welcome?:	Yes No	Weekends Free?:	Yes No
Evening Babysitting:	Yes No
4 weeks holiday per annum:	Yes No	Net Salary:
Use of car provided:		To select multiple items, please hold down the Ctrl key on your keyboard and click on the required items.
Interview expenses reimbursed.	Yes No	Contract required:	Yes No
Medical Insurance provided:	Yes No	Return AirFare paid:	Yes No

Credit Card Details:
If you wish you may send your Credit Card details by fax or telephone:
Send credit card details by:	Fax Telephone This form
Cardholder Name:
Billing Address:
Card No.:
Start Date:
Expiry Date:
Issue Number:	(If Switch)
Card Type:
If Other, please specify:
I agree to payment being automatically debited to my account.
How did you hear about Eden Nannies & Maternity:*
If recommendation, by whom:
If Other, please specify:
Yes I have read the relevant Terms & Conditions of Business: *

Disclaimer:

I confirm that the information on this online form is accurate and supplied in good faith to the best of my knowledge and belief and furthermore, I have read The Agency`s Terms and Conditions of Business and agree to be bound by them and to pay the Agency`s fees and charges in accordance with those Terms and Conditions of Business. I request The Agency immediately to endeavour to find a suitable employee(s) for me...

By submitting this application you are agreeing to the Terms and Conditions of Business set out in previous pages.


	Click here for more information & our online Client Registration form


	Click here for more information & our online Candidate Application form