Please register as a client either by

Your Family Details

Home Phone
Mobile Phone
Work Phone

Fathers's Occupation

Mother's Occupation


Ages & gender of children

Do any of your children need special care or diet?
If so please give details

Do you employ other domestic help?
Do you keep any pets?


Type of help required

Dates required

Days of work anticipated

Hours of work anticipated

Duties required

If live in postion, please give details of accommodation offered.

Further Details

Do you require a car driver?

Is a car provided?
If yes, is it available for use in own time?

Is employee expected to travel with family on holiday or business?

Have you previously employed childcare help?

Would you consider a male employee?

Would you consider an employee with own child?

Age of employee preferred?

Do you require the employee to be trained?

Salary offered (Please state weekly or monthly and net or gross)

Please give further details or requirements you feel may be of assistance to us when selecting suitable candidates.

Where did you hear about us

Please confirm you have read and accepted our Terms & Conditions and Placement Fees

Mothers Help
Maternity Nurses

Childcare Consultancy
First Aid Courses

Taking care of your family.