Application Form For Nannies, Mother’s help Housekeepers and Live in Couple’s

Are you looking to become a nanny, mother's help, housekeeper or live in couple? Please fill in our online form

Your Name (required)

Marital Status:

Date Of Birth:

Your Address (required)

Your County (required)

Post Code:

Your Daytime Phone Number (required)

Your Evening Phone Number (required)

Your Mobile Phone Number

Your Email (required)

Skype id:

Next of Kin:



What sort of position do you require?:

Day / Live In / Either:

What type of Position?:

Preferred Location:

Number of children preferred:

Ages of children preferred:

When could you start?:

Minimum salary required:

Can you drive?:

Do you have your own car?:

Have you had any previous convictions?:

If 'YES' please give details:

Do you have a valid passport?:

Can you speak any other languages?:

If 'YES' please give details:

Do You Smoke?:

Do you like animals?:

Do you have any allergies?:

If 'YES' please give details:

Do you have any special dietary requirements?:

If 'YES' please give details:

What hobbies do you have?:

Are you in good health?:

If 'No' please give details:

Please list all GCSE and 'A' Level passes (Or equivalent)





Child care Qualifications



College Attended:

Please give details of your last two employers

Employer Name :

Employer Address:

Telephone Number:

Position Held:

Dates of employment,


Ages of children:

May we contact them for a reference?:

Employer Name 2:

Employer Address 2:

Telephone Number 2:

Position Held 2:

Dates of employment,


Ages of children:

May we contact them for a reference?:

If "no" please supply details of two people whom we may ask for a reference (these must not be family)



Telephone Number:


Name 2:

Address 2:

Telephone Number 2:

Relationship 2:

NB: Nannies or Parent Helpers are not charged for this service. We do our utmost to find suitable placements for our staff but cannot guarantee that employment will be found.

If any of the above information is misleading or untrue in anyway, we reserve the right to remove the applicant from our register of employment.

Declaration: I hereby declare that the information on this form is correct and may be used by Richmond & Twickenham at their discretion.

I give consent for Au Pairs Nationwide (Richmond & Twickenham) to process, collect and store my data from this form in a secure and protected manner which is GDPR compliant. I understand that I have the right to withdraw it any time.

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