Full
Name
Maiden
Name (if applicable)
Sex
Male
Female
Date
Of Birth
Address
Telephone
(Day)
Telephone
(Eve)
Mobile
Email
Nationality
Religion
Smoker
No
Yes
Driver
Yes
No
Car Owner
Yes
No
Qualifications
Year
Obtained
Other
Courses
Do
You Have A First Aid Certificate
Yes
No
Do
You Have First Aid Experience
Yes
No
Passport/Visa
Details
If
you do not hold a British passport, do you hold
a valid work permit
Yes
No
Driving
Licence number
National
Insurance Number
Do
you have any dependants
No
Yes
If
yes, please give details
What
is your partners occupation (if applicable)
Do
you have brothers & sisters
Yes
No
Is
this your first job
Yes
No
Have
you ever lived away
Yes
No
Are
you familiar with the area
Yes
No
Do
you speak any other languages, please state
Please
indicate level of fluency
Do
you have any special diet
Are
you in good health
What
are your hobbies and
What
level of housework are you willing to undertake
Ironing
Yes
No
If
you are vegetarian,
Yes
No
Would
you object to us
No
Yes
What
is your cooking like
Poor
Average
Good
Excellent
Other
When
would you be able
How
did you hear about Wimbledon
Nannies
Are
you able to provide proof of identity, qualification certificates
(including first aid), passport, work permit (if necessary),
driving licence and any other relevant documents
Yes
No
Are
you happy for Wimbledon Nannies
to
send out your CV and / or references to a prospective
employer
Yes
No
Details about your driving history :
Did
you pass your driving test first time
Yes
No
Have
you been driving ever since passing your test
Yes
No
Date
you passed your test
Any
endorsements
No
Yes
If
yes, please explain
Do
you have any penalty points on your licence
No
Yes
If
yes, when and why
Have
you ever been
No
Yes
If
yes, when and why
How
long have you
What
type of car have
Automatic
Manual
Both
Would
you use your car
Yes
No
Does
it have rear seat belts
Yes
No
Police Check
Do
you have a police record
No
Yes
Have you ever been
police checked
No
Yes
If
yes, when and by whom
School
Attended
Address
GCSE's
A
Levels
Date
Left
Further Education
College
/ University Attended
Courses
Studied
Qualification
Achieved
Date
Left
Age
on leaving
Do
you hold a current
Yes
No
Expiry Date:
Employment
History
Current
or most recent position
Date
started
Date
left
Employers
Name
Address
Telephone
No.
of Children : Girls
Boys
Ages
: Start
Finish
Position
held
Sole
charge
Yes
No
Reason
for leaving
Do
you have a written reference
Yes
No
Previous
Positions
Previous
Position 1
Date
started
Date
left
Employers
Name
Address
Telephone
No.
of Children : Girls
Boys
Ages
when you began
Position
held
Sole
charge
Yes
No
Reason
for leaving
Do
you have a written reference
Yes
No
Previous
Position 2
Date
started
Date
left
Employers
Name
Address
Telephone
No.
of Children : Girls
Boys
Ages
when you began
Position
held
Sole
charge
Yes
No
Reason
for leaving
Do
you have a written reference
Yes
No
Previous
Position 3
Date
started
Date
left
Employers
Name
Address
Telephone
No.
of Children : Girls
Boys
Ages
when you began
Position
held
Sole
charge
Yes
No
Reason
for leaving
Do
you have a written reference
Yes
No
Requirements
Type of post required (enter one or more) Duration
of work (enter one or more)
Work Category
(enter one or more)
How
old was the youngest child you have looked after
What
is the age range of the children you would like to look after
How
many children would you be happy looking after at the same
time
Would
you be bored with one
Yes
No
If
live in, what sort of accommodation are you looking for
If
you are looking for a share, give brief details about
the job you are trying to keep
Are
you looking for a sole charge position
Yes
No
How
do you feel about mum/dad working from home
How
do you feel about mum/dad being around generally
What
hours are you looking to work
How
much babysitting would you do
What
level of wages are you looking for
What
salary are you on at present
Any
other comments or additions to the above
