Family Looking for Housekeeper Registration Form

Client Full Names Professions Address Including Post Code
Home Number Mobile number Email Address
How did you hear about our Agency?
Type of Housekeeper required Starting Date Is driving essential? If so do you provide a car or expenses
What sort of accommodation will you provide for Live In help Do you have any children? If so will the Housekeeper be responsible for any childcare duties? Do you have any pets? If so will the Housekeeper be responsible for them?
Do you employ any other Household Staff? Will the Housekeeper be expected to travel with you? Are there any Safety / Health Risks in the place of work - If Yes please provide a full description
Please provide basic job description and duties required
Days off per week Holiday entitlement for employee per year (minimum 28 days Including Bank Holidays) Rate of Pay
Have you had a Housekeeper before? How did you hear about our Agency?  
I am signing below to confirm I have read and understood the Terms and Conditions of the Northern Nanny Agency and agree to abide by them. I agree to the best of my knowledge that the information given in this application form is complete and accurate.

I agree to inform The Northern Nanny Agency by telephone when I have engaged an applicant and confirm the engagement in writing within seven days. I can confirm that in the event of employing someone through the Northern Nanny Agency, I will be responsible for payment of the invoice.
Client Signature:- Date:-
Client Signature:- Date:-
Agency Signature:- Date:-
I agree to The Northern Nanny Agency terms and conditions