Elizabeth Henry Nannies, Nanny Agency



Childcarers Registration

* Indicates the mandatory fields.

Your Details
Title*
First Name*
Last Name*
Address 1*
Address 2
Town / Village*
County*
Postcode*
Telephone*
Mobile
Email*
Confirm Email*
Date of Birth*
Age*
Nationality*
Marital Status
Maiden Name
Dependants and ages


Are you seeking a position which will allow you to take your child to work with you?

Do you have back up childcare arrangements in place?

Please provide any further details which you feel may be relevant


Education and Experience
Secondary School Attended*
Year attended from*
Year attended to*
Number of GCSE's taken. Grades A-C*
Grades C+ *

College Attended*
Year attended from*
Year attended to*

Childcare Qualifications*


Please state any other qualifications

Do you hold a Food Hygiene Certificate?*
How many years Childcare experience do you have?*
How many years Sole Charge experience do you have?
Ages of children you have had sole charge of?


Have you cared for multiple births before?
Have you cared for a child with Special Needs before?*
Have you cared for a child that has special dietary requirements before?*

Do you hold a Criminal Records Beauru (CRB) Enhanced Disclosure?*

Date of issue if held

Please note: To register with Elizabeth Henry Nannies you are required to hold a CRB Enhanced Disclosure. We can arrange this for you should you not already have one.


Do you hold a Peadiatric First Aid Certificate?*
Date of issue if held
Are you currently Ofsted Registered?*
Date of Registration
Are you willing to become Ofsted approved?*
Do you drive?*
Do you own a car?*
Are you willing to use your own car for work purposes?*
Do you hold a clean driving Licence?*

If no to any of the above questions please provide details


Current Employment Details
Are you currently employed?*
If yes, when did you start?
If no, when did you leave?
If you are looking to hand in your notice, how long is your notice period?

What date are you available to start work?
What position do you currently hold*


Other postion

If you are working as a Nursery Nurse which rooms are you currently working in?


Ages of children currently Nanny for? Gender Age
Child 1
Child 2
Child 3
Child 4
If the options above do not explain your current employment please provide details here


Job Requirements
What type of position are you looking for?*




Days Required*

Hours prepared to work? eg 7am to 7pm*

Are you available for ad hoc evening babysitting?

From what time?

What duties are you willing to perform?*



What is your preffered age range?*


Maximum number of children to care for?*

Would you consider working for a family where a parent works from home?*

Would you be happy caring for a child with special needs or a disability?*

Please specify your required net weekly salary or hourly rate

Please indicate which areas you are willing to work:


Would you be interested in working as a temporary nanny / mother’s help in between jobs?*

Do you smoke?*
Are you willing to work for a smoking family?*
Can you swim?*
Do you play a musical Instrument?*
If so which instrument
Do you speak a foreign language?*
If so which language
Do you play a sport?*
If so which sport
Are you happy to cook meat for a family?*
Do you have any allergies or phobia's that could affect you at work?*

Please give details


Please use the space below to list any hobbies or interests you have, please list at least three*


Medical History
Do you have or have you had in the last 5 years had any physical problems requiring specialist Referral?*

Do you have or have you had any mental health problems in the last 5 years?*

Have you, at any time, suffered from mental or physical health problems which could affect your ability to work as a childcarer with sole charge of young children?*


Are you taking any regular prescribed medicines?*

Do you have any medical requirements which may effect your work?*


If you have answered yes to any of the above please give details below


Where possible please attach your current C.V. here
Please note that attaching your current CV here will help speed up the process of your registration

I certify that the above information is correct.  I understand that all information passed to myself from Elizabeth Henry Nannies with regards to prospective employers is to be treated in the strictist of confidence and must not be passed on to a third party.

Tick here to confirm you agree to the above statement