Photo Nanny Options Candidate Application Form Personal Details: Full Name: Current address: Date of Birth: Email Addresses: Mobile Number: Home Number: Skype Address: Nationality: Next of Kin: Marital Status: Do you have any criminal convictions: Visa Requirments: Next of Kin Tel No: Do you have Children: Do you smoke: Swimmer: Cooking skills: Driver: Provisional License: Full License: Own car: Passport: Any endorsements: Travel Overseas: Languages: Nanny: Full/Part Time: Temporary: Maternity Nurse: Days/Nights: Availability: Housekeeper: Full/Part Time: Temporary: Location: Live In: Hobbies/Interests: Type of Position: Live Out: Health Status: Are you taking any medication: Allergies: Secondary Education: Name of school: Date: Location and Qualification: Further Education: Name of College/University: Date: Location and Qualification: Employment History: Employers Name & Contact Details: Position: Number of Children and Ages: Address: Reason for Leaving: Employers Name & Contact Details: Address: Position: Reason for Leaving: Number of Children and Ages: Employers Name & Contact Details: Address: Position: Reason for Leaving: Number of Children and Ages: Employers Name & Contact Details: Address: Position: Reason for Leaving: Number of Children and Ages: Employers Name & Contact Details: Address: Position: Reason for Leaving: Number of Children and Ages: Additional Information: PLEASE INSURE THE FOLLOWING INFORMATION IS INCLUDED WITH YOUR APPLICATION FORM. Copy of Qualification Written Reference from Previous Employers Telephone Numbers of Previous Employers First Aid Certificate Garda Vetting Application Form Two Original Passport Photographs An Original Passport An Original Driving License A list of Pervious and Current Address How did you hear of Nanny Options: Declaration: I confirm that all the information contained within this application form is correct. I understand that should I obtain a position through Nanny Options that I will notify the agency immediately. I agree that all the information I receive about any clients or candidates is confidential and I understand that this information shall not be discussed without consent. I give my consent to Nanny Options to check this information. Signature: Address: Nanny Options, Suite 4, Block E2, Nutgrove Office Park, Rathfarnham, Dublin 14. Date: Tel No. : 015331986 Mobile No. : 0878144299 www.nannyoptions.ie Email Addresses: info@nannyoptions.ie teresa@nannyoptions.ie Nanny Options, Suite 4, Block E2, Nutgrove Office Park, Rathfarnham, Dublin 14. Tel: 015331986, 0877465265. The information contained within this document is confidential
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