Registration Back to Carers page If you are looking for a position, please complete the following form and we will get back to you as soon as we can. It should take approximately 5 mintues to complete. Thank you.   Personal   Title First Name Surname Address Postcode Telephone:   Home Work Mobile Email Address Age Date of Birth Nationality Religion Next of kin Marital Status Can you swim? Hobbies? Do you have any brothers and sisters? Can you play any musical instruments? Do you speak any foreign languages? Do you suffer from any serious illnesses or allergies? >> Select Yes No Do you smoke? >> Select Yes No Do you have a child / children of your own? Do you have any pets? >> Select Yes No   Qualifications & Experience   How many GCSE's / O Levels do you hold? Are you a qualified child carer? >> Select Yes No How many years experience do you have? Please specify your qualifications:   Employment History   Name of employer Present position Telephone number Period worked Ages and sexes of children Reson for leaving   Previous employer Position Telephone number Period worked Ages and sexes of children Reson for leaving   The position you are seeking:   Nanny Nursery Nurse Mothers Help Baby Sitter Full Time Part Time Daily Live In   If Live In do you require?:   Own Room Separate Accomodation Would you consider a position with a parent at home?     Are you willing to do:   Light housework Full housework Nursery duties only Flexible   Please specify the location(s) you wish to work in How much notice is required in your present position? What date are you available to start in a new position? What net salary are you seeking? What is your current net salary? Do you have a valid CRB police check? >> Select Yes No Paediatric First Aid Certificate expiry date(if held) How did you hear about Coralis? Which other Agencies are you registered with? Any additional information?   Driving   Do you hold a clean driving licence? >> Select Yes No If not, please give details of driving offences Do you have your own car? >> Select Yes No     I agree to abide by the Coralis Childcare Agency terms and conditions     Upon processing of the application we will contact you as soon as possible.