Family Name Required
First Name Required
Address
Postcode Required
Home Telephone
Mobile
Email Required
Childs Name [1]
DOB
Child's Gender MaleFemale
Childs Name [2]
Childs Name [3]
Childs Name [4]
Help Required Mother's Help Nanny House Keeper Maternity Nurse
Hours of work required?
Days required? Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Live in YesNo
Will the applicant have sole charge of children for long periods (i.e. if both parents are working)? YesNo
Do you have any pets? YesNo
If yes, please provide details
What kind of personality/qualities are you looking for in a candidate?
What accommodation is available if live-in help required? House Own Room Own Bathroom Shared Room Shared Bathroom Own TV Self Contained Room Other
Would you require a car driver? YesNoNot Essential
Is there a car available for the nanny? Yes - Sole UseOccasional UseNo
What duties will be required? Childcare Children's Cooking Family Cooking Driving Children Light Housework Shopping Children's Ironing Family Ironing
Salary Offered
Preferred Start Date
Duration of Employment
How did you hear of Family Match? Yellow PagesNewspaperFriend (name)PosterAdvertInternetOther
