Full Name *

Address (please include post code) *

Local metro *

Age *

Phone *

Mobile *

Email address*

Nationality *

NIE number / passport number *

Languages spoken *
(please state level - mother tongue / fluent / intermediate / basic)

Position required (please tick boxes)
 Nanny

Education History *
(including all qualifications relevant to areas listed above)

Relevant experience *
(please include dates worked)

Days and times available *

EU driving license *
 Yes No

Car / moto owner?
 Yes No

If so have you ever had an accident?
 Yes No

Do you smoke?
 Yes No

Do you have any recurring medical problems? Including asthma or allergies?
 Yes No

If so please give details:

Contact / reference details *
** Please give the names and phone numbers of two people who would be prepared to give you references relevant to the employment area in which you are interested? Non family references only please **

Declaration for all applications

Has a child ever had an accident whilst in your care?
 Yes No

If so, please give details

Do you have a police record? *
 Yes No

If so please give details

Do you have a police check document? *
 Yes No

If not are you prepared to obtain one? *
 Yes No

FINAL DECLARATION

I certify that the information set out above is true and correct. I authorize TLC to use this information, without prejudice at tits sole discretion. I further authorize TLC to verify and references which I have supplied. I will treat all information given to me regarding vacant positions as confidential and will no pass on any names and addresses of potential employers to any person or give any personal information or contact details to any client or potential client of Tender Loving Canguros. If I obtain a position through Tender Loving Canguros I will notify them at once and will notify the employer concerned that the agency fee will apply.
 I Agree I Disagree