Millennium Nannies
Millennium Au Pairs is
a long established UK based
Au Pair agency, our candidates
are all fully vetted.
 


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Millennium Au Pairs & Nannies,
The Coach House,
The Crescent,
Belmont,
Sutton,
Surrey SM2 6BP,
ENGLAND.
Tel: +44 (0)208 241 9752
Family Application Form for a Nanny/Mother's Help/Housekeeper
Application for an:
Nanny Mothers help Housekeeper
Your full name
Please upload an image of your family:
Nationality Age
Home Address    
Locality of your home
Are you based in a City/large town/small town/village/countryside
Nearest city/town: Travel time: Available transport/frequency
Nearest Bus: Railway station: Underground station:
 
Local amenities (please give details):
Expected salary:
Permanent or temporary:
Full or part time:
Live in or live out:
Contact Details:
Home Tel. Work telephone numbers Mobiles Father\Mother
 
Fax Numbers (Home and work) Email Address
Husband's Occupation: Mother's Occupation:
Religion Mother Religion Father Practising?
Family ethnic origin: Mother? Father: Children:
Are any languages other than English spoken in the home? If so which, and how often?
Do any relatives live permanently with your family? If so please give details, including age and authority of that person in relation to the Nanny/Mother's Help:
Type of family accommodation :
Accommodation offered to Nanny/Mother's Help/Housekeeper :

Other (please give details):
Will she have her own:
Please list your family's main hobbies and interests, including those of the children:
Please list the children by name, age, date of birth and sex (starting with the eldest):
Name: Date Of Birth: Age: Sex:
Do any of the children have a handicap, illness or learning disability? If so, please give full details below and explain what care or support is required of the nanny/mother's help/housekeeper :
Do any of the children have any serious allergies? If so, please give full details and explain what action is required of the nanny/mother's help/housekeeper :
Have you ever employed a Nanny/Mother's Help/Housekeeper before?
If yes, when did your last Nanny/Mother's Help/Housekeeper cease to be employed?
Are you willing for us to obtain a reference from any previous Nanny/ies /Mother's Help(s)/Housekeeper(s) ?
If yes, please give name(s), address(es) and telephone number(s) below:
Name Address Contact Number
Details and Duties of the Nanny/Mother's Help/Housekeeper you wish to Employ:
Do you require a fully qualified NNEB Nanny or person with an equivalent overseas diploma?
Would you employ a suitably experienced Mother's Help who does not have a formal qualification, subject to suitable references being obtained?
Please number the following in order of preference (1 being prefferred):
Live In role: Live Out role: Indifferent:
Ideal age of applicant (please select):
Childcare Duties
Please summarise below the role which your Nanny/Mother's Help/Housekeeper will be expected to play in relation to the each of the children, including your expectations with regard to play, stimulation, outings, homework supervision etc:
What type of personality would best suit your children eg sporty, artistic, musical, etc
Do you require your Nanny/Mother's Help/Housekeeper to drive as part of her duties?
Will Nanny/Mother's Help/Housekeeper need her own car?
If no, please state whether a car will be provided, including model and type, manual or automatic:
Will the car be also be available for private use?
If yes, please state any conditions or restrictions below:
If the Nanny/Mother's Help/Housekeeper is expected to use her own vehicle as part of her duties, please state amount which will be paid for wear and tear and whether additional insurance costs incurred for use of the vehicle during work hours will be compensated for:
How much driving will be required? Please give details of driving duties, including distances where appropriate and estimated journey times:
When do you require the Nanny/Mother's Help/Housekeeper to start work?
Minimum length of employment? Weekly net salary range offered?
Will you accept a smoker if she undertakes never to smoke in the home or in view of the children?
Do any family members smoke in the home? If yes, how many and in which areas?
Will you consider a male Nanny or Mother's Help/Housekeeper?
Will you consider a vegetarian? Are any members of the family vegetarian?
Is it essential for your au pair to be a swimmer?
Do you have any family pets? If so, please state type and race below and clearly outline any duties the nanny/mother's/housekeeper help may have in relation to them:
Please state what type of domestic chores the Nanny/Mother's Help/Housekeeper will be expected to carry out and estimated number of hours per day:
Duties
Yes/No
Estimated hours per day
Cooking for the children
Cooking for other family members
Cleaning up after the children
Washing and ironing for children
Washing and ironing for all the family
Tidying up after the children
Dusting
Hoovering
Will you be employing any other home help?
If yes, please give details and number of hours they will work below:
How many hours of work do you require from the Nanny/Mother's help/Housekeeper per day?
Please state exact working hours from Monday to Friday:
How many complete days off will the nanny/mother's help/housekeeper have per week?
Will any weekend working be required? If so please give details below:
Will any overnight stays ever be required? If so, how often?
Will additional evening babysitting be required?
If so, how many evenings per week?
Is babysitting/overtime optional?
Please state hourly rate for babysitting/overtime, including overnight stays:
Will the nanny be required to accompany the family on overseas trips and holidays?
If so please state likely frequency, times of year and countries to be visited:
Paid annual leave: How many weeks' fully paid annual leave will the nanny receive?
Please give details of any other perks or benefits eg: air fares home/gym membership/other:
House Rules
Will you allow a family member or boyfriend to stay in your home?
Will the Nanny/Mother's/Housekeeper Help have use of a telephone line?
What restrictions will be placed on overseas or long distance calls?
When not working the following day, will you allow the Nanny/Mother's Help/Housekeeper to keep very late social hours?
Is there a definite time by which you would always expect her to be home? If so, please indicate that time:
Declaration:
I/We agree to the charges and terms and conditions of business specified by Millennium Nannies. I/We confirm that I/we have received a copy of the agency's terms and conditions. I/we also certify that all the information given on this form is correct and that the conditions of employment and remuneration described are accurate. I/We agree that any amendments to the above will be agreed with Millennium Nannies and embodied in the Nanny's formal contract, a copy of which will be provided to the agency as soon as a formal job offer is made. View terms
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