Nannies of St James
100 New King's Road
London
SW6 4LX
+ 44 (0) 845 658 1961
nanniesstjames@aol.com
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Client Profile Form
Personal Details
Title *
Mr
Mrs
Ms
Miss
Rev
Dr
First Name *
Last Names *
Address 1 *
Address 2
City *
County *
Postcode/Zip *
Country *
Albania
Algeria
Angola
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Bolivia
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Cambodia
Cameroon
Canada
Chile
China
Colombia
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
French Polynesia
Gambia
Georgia
Germany
Ghana
Greece
Guam
Guatemala
Guyana
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Libya
Lithuania
Luxemburg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Malta
Mauritania
Mauritius
Mexico
Moldova
Mongolia
Morocco
Mozambique
Namibia
Nepal
Netherlands
New Zealand
Nigeria
Norway
Oman
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Republic of Ireland
Reunion
Romania
Russia
Rwanda
Samoa
Saudi Arabia
Senegal
Singapore
Slovakia
Slovenia
South Africa
Spain
Sri Lanka
Sudan
Swaziland
Sweden
Switzerland
Taiwan
Tanzania
Thailand
Trinidad and Tobago
Tunisia
Turkey
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Venezuala
Vietnam
Yemen
Yugoslavia
Zambia
Zimbabwe
Home Telephone *
Mobile
Main E-mail*
For e-mail correspondence
Business Telephone
Business Fax
Alternative E-mail
Mothers Occupation
Mothers Age
Fathers Occupation
Fathers Age
Childrens Details
Child 1 Name
Age
Gender
Male
Female
Child 2 Name
Age
Gender
Male
Female
Child 3 Name
Age
Gender
Male
Female
Child 4 Name
Age
Gender
Male
Female
Child 5 Name
Age
Gender
Male
Female
Child 6 Name
Age
Gender
Male
Female
Do any of the children require special medical care? If so please specify:
Please tick the box if a new baby expected
if so what is the anticipated date
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January
February
March
April
May
June
July
August
September
October
November
December
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Residence Details
Type of Residence
House
Apartment
Farm
Country Estate
Location
City
Town
Village
What languages are spoken at home? *
Are there any smokers in the house? *
Yes
No
Please specify any household pets *
Do you require a driver?
Yes
No
Car Type
Manual
Automatic
Will the employee have use of car?
Yes
No
Is your household formal or informal
Formal
Informal
Details of the position
Type of Staff
Nanny
Mother's Help
Maternity
Type of Position
Temporary
Permanent
Daily/Live-in
Daily
Live-in
When is the vacancy to commence?
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January
February
March
April
May
June
July
August
September
October
November
December
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
(approximate date)
Duration of Position
Prefered age range
Is a non smoker essential?
Yes
No
Will your employee be required to undertake any of the following:
Children's duties
Light housework
Laundry
Cooking
Grocery Shopping
Errands
Will your employee have sole charge of the children?
Yes
No
Will some babysitting be required?
Yes
No
What are the anticipated working hours?
What type of accommodation is offered?
Weekly salary offered, in Pounds Sterling
Please provide any additional information that might prove helpful in fiding the most suitable candidate for your family,
this might include childrens hobbies and interests, other residences and holiday destinations.
I have and read and accept the
Terms and Conditions
.
If the form is succesfully submitted an e-mail from nanniesstjames@aol.com will be sent to you main e-mail address. A representative from the agency will contact you to discuss the finer points of the vacancy. Please ensure your telephone numbers and email address are correct prior to submitting the form.
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