Employer registration form

Complete the Employers Registration Form:

PERSONAL DETAILS

Full Name:
Address:
Town:
County:
Postcode:
Tel (Home):
Tel (Mobile):
Email:
Mother's Occupation:
Father's Occupation:
Please list the names and dates of birth of your children:

Is a new baby expected? If so when:

Please give a brief description of the family's main interests and activities:

EMPLOYEE REQUIREMENTS

Requirement Type:
Qualified Nanny
Experienced Nanny
Mothers Help
Maternity Nurse
Housekeeper
Gardener
Couple
Babysitter

Temporary or Permenant?:

Please give a start date and the likely duration of appointment:

Live in or out?:

Please describe accomodation (e.g. own room/T.V./bathroom):
Do you need:

Any other requirements (e.g. rider, swimmer, non-smoker):

EXPECTED DUTIES

Please outline the expected duties and hours (e.g. sole charge, babysitting, general help):

Would the nanny accompany your family on holidays, etc? If so, please give details:

SALARY OFFERED (week, month, per annum - gross/net):

I have read and agree to be bound by the Terms and Conditions of Poppins. Please tick:

Poppins Agency

Household Staff Specialists - call us on 01373 815313

Complete the Employers Registration Form: