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If you are looking to employ a child carer, please complete the following form and we will get back to you as soon as possible.
Mother's Personal Information
  
First name
Surname
Address
Postcode
Home Telephone:
Nationality
Religion
Occupation
Work telephone (if applicable)
Mobile telephone
Email address
Father's Personal Information
  
First name
Surname
Address (If same as 'Mother' please leave blank)
Postcode
Home Telephone:
Nationality
Religion
Occupation
Work telephone (if applicable)
Mobile telephone
Email address
Your Home
 
Is your home
Do you employ any household staff?
Do you have any pets?
Your Children
  
Boys
Girls
Their ages and type of Nursery/School attended:
 
Boys
Girls
Particular interests or hobbies

Do any of your children require special care?
Your Requirements
  
   
Nanny (qualified)
Nanny (just experienced)
Mother's Help (qualified)
Mother's Help (experienced)
Babysitter
Full Time
Part Time
Daily
Live In
Would you consider employing a nanny that brings her own child to work?
   
   
Car driver essential?
Would car be available on duty?
Would car be available off duty?
Starting date
Length of stay?
 
 
Nursery duties only
Some light housework
Full housework
Cooking:
Will carer have sole charge?
Daily hours:
  
Start
Finish
Days per week
Number of days annual holiday offered:
Weekly Babysitting hours (if appropriate)
Maximum net salary per day or week
Any additional information? Please give further details of the type of person you are looking for and any useful information about your family!

Please mention how you heard of  Coralis Childcare Agency:
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.