| Name: | |
| Email Address: | |
| Address (including state) | |
| Postcode | |
| Country: | |
| Date of Birth (Day/Month/Year) | |
| Contact numbers: (Home, mobile and work where applicable) | |
| Best time(s) to reach you: | |
| Nationality: | |
| What type of position are you seeking? |
Permanent
Temporary/casual (day) Full-time Part-time Live-in Live-out Babysitter (night) Mothers helper |
| Date available: | |
| Driving record: |
I have a current drivers license
I do not have a current drivers license I can drive manual I can drive automatic I have a clean driving record I own a car I have experience driving employers car(s) I would feel competent driving an employers car I would prefer not to drive an employers car |
| If you have any traffic violations within the past five years, please give details. | |
| Other relevant details: |
I smoke
I like animals I have animal allergies (please provide details below) I can cook I am willing to cook (for children) I am willing to cook (for family) I am willing to do housework (for children) I am willing to do housework (for family) |
| Do you speak any languages other than English? If so, which languages and how fluently? | |
| CHILDCARE EXPERIENCE I have had experience with |
Newborns
3- 9 months 9 months to 2 years 2 years to 3 years 3 years to 5 years 5 years to 10 years Older than ten years Special needs children Twins or triplets As a sole carer As a mothers helper As an aupair |
| Please briefly provide details of your experience. (Please note, you will need to provide contactable references from at least two past/current childcare related employees) | |
| What skills/talents do you possess that would be helpful when caring for a child? (i.e. can swim, have a background in arts and crafts etc.) | |
| Which days and hours would you be available to work? (please specify which is for nannying/babysitting if you are registering as both a nanny AND a babysitter) | |
| Which days are best for you to be interviewed on? |
Monday
Tuesday Wednesday Thursday Friday Saturday Sunday |
| Please provide any details or comments you think are relevant or helpful to us. | |
| How did you hear about Lil' Ones Nanny Agency'? | |
| I declare that all the information I have supplied is true and accurate to the best of my knowledge. I understand that Lil' Ones will contact me soon for an interview and reserves the right to refuse applicants. Please respond with "yes" if you agree |
I agree to the above terms |
