Fees:

Full Name: *

Full Postal Address: *

Home Phone:

Work Phone:

Fax No.:

Mobile No.:

E-mail: *

Marital Status:

Nationality:

No. of resident adults:

No. of children:

Boys ages: (Example 1, 3)

Girls ages: (Example 1, 3)

Baby due date:

Husbands Occupation:

Wife's Occupation:

Description of house:

Second house:

 Other Staff:

Household Animals:

Requirements:

I require a:

Contract type:

Further Details: Box provided for extra details e.g.: Days & Hours etc.

Type of Charge:

If temporary, duration of post:

Job commencement date:

Driving details:

Smoking details:

Age preferred:

Experience:

Personality:

Duties:

Please state any special dietary requirements (Vegetarian, Kosher) and any other duties not listed above::

Employment Details:

Accommodation Offered:

Pets welcome?:

Weekends Free?:

Evening Babysitting:

4 weeks holiday per annum:

Net Salary:

Use of car provided:

Interview expenses reimbursed:

Contract required:

Medical Insurance provided:

Return Airfare paid:

Credit Card Details:

If you wish you may send your Credit Card details by this form, fax or telephone just choose which one from the following:

Cardholder Name:

Billing Address:

Card No.:

Start Date:

Expiry Date:

Issue Number: (If Switch)

Card Type:

If Other, please specify:

How did you hear about Eden Nannies & Maternity:

If recommendation, by whom:

If Other, please specify:

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:*