Nannies and Childcarers Registration

Please fill in the form below. To submit a completed registration you will be required to complete your 5 year career history on page two of this form. Any necessary amendments can be made during your registration interview.

* indicate the required fields

Personal Details
Page 1 of 2
*Title:
*First name:
*Last name:
*Address Line 1:
Address Line 2:
*Town/Village:
*County:
*Postcode:
*Country:
Phone number:
*Mobile:
Work number:
Fax number:
*Email:
*Re-enter email:
*D.O.B:
*Nationality:
*Marital Status:
Number of dependants:
*How did you hear about us?:
Education, Experience & Qualifications
Education:
Norland
Princess Christian
Chiltern 		ADCE
NNEB
NVQ2 		NVQ3
Cache2
Cache3 		BTEC
NAMCW
MNT 		Other
Ages of Children Cared for:
0-3 Months
3-5 Years 		3-12 Months
5-12 Years 		1-3 Years
12+ Years
Number of years experience:
*Are you permitted to work in the UK?: Yes
No
Current Enhanced Disclosure issue date (if held - dd/mm/yyyy):
Tigerlily Childcare can arrange an Enhanced Disclosure for a fee of £56 (please make cheque payable to Tigerlily Childcare Ltd)
Paediatric First Aid Certificate expiry date (if held - dd/mm/yyyy):
*Do you have a driving licence?: Yes
No
*Do you own or have access to a car?: Yes
No
Which, if any disabilities have you had experience in dealing with?:
*Have you cared for twins before?: Yes
No
*Have you cared for children with special dietary requirements?: Yes
No
Which local nurseries (if any) have you previously worked for?:
Which other agencies are you registered with?:
Position Required
Type of work sought: Nanny Mother's Help Nursery Senior Nursery
*Employment Basis: How long if temporary?:
*Employment sought:
Preferred age group to care for:
*Maximum number of children to care for:
*Area required:
*Accommodation:
*Would you consider a position with a parent at home?: Yes
No
*Would you consider a position in a Nursery whilst waiting to find your ideal position?: Yes
No
*Would you be prepared to occasionally help out with light house work?: Yes
No
Days required: Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Notice Period:
Salary range required (net):
Current net monthly salary?: