Application Form

Clients Registration Form – Please complete relevant sections.


Where did you hear about THANK EVANS?
Mother’s name
 
Father's name
Address:
Home tel. no
Mother's mobile no.
Post Code
Father's mobile no.
Fax
Email
Mother's Occupation
Father's Occupation
Mother's Work Tel No.
Father's Work Tel No.
Alternative Emergency Contact
and Telephone No.
If you have provided an email address would you prefer your invoice’s to be sent there?
Family Nationality
Family Religion (and any bearing this may have on daily life
Do you have any pets? (pls give details)

Children's Details
Name
Gender: Date of Birth (dd/mm/yyyy)
/ /
Name
Gender: Date of Birth (dd/mm/yyyy)
/ /
Name
Gender: Date of Birth (dd/mm/yyyy)
/ /
Name
Gender: Date of Birth (dd/mm/yyyy)
/ /

Are any more children expected?
(please give details)
 
Children's GP GP's Telephone Number
GP's Address

Please also provide the following information.
Does your child have any:
Allergies (please include any treatments)
Medications
Phobias
Comforters
Other
Service/s Required - please tick those relevant and include other information where applicable
Canidate to be employed by Thank Evans - please see accompanying documents labelled R/F
Permanent - please give start date (dd/mm/yyyy) / /
Temporary - please give length of cover
Ad-hoc - please give any available information
Nanny Maternity Nurse Mother's Help Babysitting Overnight Care Night feeds
Other (please specifiy)
Full-time Part-time Evenings Weekends Live-in Live-out
Sole Charge To work alongside parent    

Days required.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Qualifications Required


Driver Required With own Car Family car available for work use
Swimmer/Active person Horse rider First Aid Trained Non Smoker
Any Special Requirements
Duties - please tick those required
Light housework Nursery Duties only - i.e. children's washing/ironing/cooking/tidying
Family Ironing School runs Pet care  
Other (please state)
Other Information
Please give a brief job description, an outline of daily routines, names of schools, school drop off/pick up times and any other information we may require.

Advertising

Please tick this box if you would like Thank Evans to place a specific Classified Advertisement regarding your childcare position (see Terms of Business R/F clause 3.9).
I confirm that I have read, understood and agree to the enclosed Terms of Business including the current fees table of Thank Evans Nanny Agency.
I confirm that I will pay the registration fee and therefore that I am asking the agency to put our family in contact with potential applicants.
I understand that should any details that have been given above change or should I locate and secure childcare elsewhere that I should inform the agency as soon as possible.
I understand that I should contact Thank Evans within 24 hours after meeting applicants so as to discuss opinions and consequent actions.
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Enter your name as confirmation of the above: Date