Surname  *

Date of Birth  *

Work eligibility in the UK  *  Yes   No 

Currently based in the UK  *  Yes   No 

Nationality  *

First language  *

Level of English  *  None   Basic   Good   Fluent 

Additional languages  *

Driver's licence  *  Yes   No   Yes but not a confident driver 

CRB (UK Criminal Records check)  *  Yes   No   In progress   No but happy to take one 

First Aid Certificate  *  Yes   Needs updating   Happy to obtain one 

Can you provide 2 references?  *  Yes   No 

Children's age group you worked with  *

Cooking skills  *  Good   Excellent   Prefer not to cook 

Childcare/teaching qualifications you hold  *

 *  Full-time   Part-time 

 *  Permanent   Temporary 

Can you commit to at least 1 year with the family?  *  Yes   No 

Can you travel with the family?  *  Yes   No 

Availability  *  Can start ASAP   Need a notice 

Postcode  *

Telephone number  *

E-mail address  *

Skype

CV with photo  *

Can you attend face-to-face interview in London?  *  Yes   No 

How did you find out about us? Google or similar  Magazines  Friends  Other 

Do you have any allergies  *  Yes   No 

Do you smoke?  *  Yes   No