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Newborn Baby, Register as a Maternity Nurse

For more information please call us on
0845 388 7098.

Register as a Maternity Nurse

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.

Personal Details

* indicates required field

*Title
*First Name
*Last Name
*Address 1
Address 2
*Town
*County
*Postcode
Phone Number
*Mobile
*Email
*D.O.B
*Nationality
*Marital Status
*Is the candidate permitted to work in the U.K?
Yes No

Education, Experience & Qualifications

Norland
Princess Christian
Chiltern
ADCE
NNEB
NVQ2
NVQ3
Cache2
Cache3
BTEC
NAMCW
MNT
Other

Number of years experience as a Maternity Nurse
Number of years experience as a Nanny
Please give details of courses completed to complement your Maternity skills
Current Enhanced Disclosure issue date
(if held - dd/mm/yyyy)
Paediatric First Aid Certificate expiry date
(if held - dd/mm/yyyy)
*Does the candidate have a driving licence?
Yes No
*Does the candidate have their own car?
Yes No
*Have you cared for twins before?
Yes No
*Have you cared for triplets before?
Yes No
*Have you cared for premature babies?
Yes No
Have you worked with babies with medical conditions? If so, please give details

Position Required

Type of work sought
Nanny     Maternity Nurse     Night Nanny
*UK Positions
UK Rate
*Overseas Position
Overseas Rate
Please add details on the type of role you are looking for
*Would you be prepared to occasionally help out with light house work?
Yes No

About You

How would you describe yourself and your areas of expertise?

 

Strict Routine
Relaxed Routine
Breastfeeding Expert
Sleep Training Expert
Excellent Medical Background
Good All Rounder
Very Experienced
Would Benefit From More Experience
Newly Qualified
Experience With Overseas Families
Prefer UK

Do they speak any foreign languages?
Yes No
If yes, please state
Do they have any allergies?
Yes No
If yes, please state
Do you have any hobbies, skills or special talents relevant to the profession?
Are you a vegetarian?
Yes No
If yes, would you prepare meat?
Yes No
Do you smoke?
Yes No
If yes, would you be prepared to not smoke on duty?
Yes No

Health Check

Has the candidate had any physical problems requiring specialist referral in the past 5 years?
Yes No
If yes, please state
Do they have, or has suffered from, any mental problems in the last 5 years?
Yes No
If yes, please state
Has the candidate at any time, suffered from any physical or mental health problems that could affect their ability to work as a nanny with sole charge of young children?
Yes No
If yes, please state
Is the candidate taking any regular prescribed medicines?
Yes No
If yes, please state
Does the candiate consent to Tigerlily Childcare contacting their GP for further information and to contacting an occupational health physician (if reguired) in connection with the above?
Yes No

Criminal Check

Does the candidate have a prosecution pending or have they ever been convicted at a court or cautioned by the police for any offence?
Yes No
If yes, please provide details of pending prosecutions, convictions and bind-over orders including the approximate date, the offence and the court or police force that dealt with the offence:

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Declaration

Has the candidate certified that the information given on this application form is true and correct and gives permission for Tigerlily Childcare to verify any references supplied. Do they also agree to treat all information given to them regarding vacant positions as confidential and agree not to pass any names or addresses of potential employers to any other person?

 

Agreed
Yes No

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Information Information

Registered Office: 3 Ditchling Rise, Brighton, East Sussex BN1 4QL

Company Number: 5207093

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