Surname (family name): *

First Names: *

Address (house name/number and street):

Town/City:

Postal Code:

Country:

Phone Number (please include the country and area code): *

Mobile Number (please include the country and area code):

Skype:

Email Address: *

Nationality:

Height:

Weight:

Age:

Date of Birth:

Place of Birth:

Passport or Identity Card Number:

When do you wish to commence employment?

Length of Employment:

Salary/Pocket Money Required:

FAMILY BACKGROUND

Father's Profession:

Mother's Profession:

Parent's Address: (if you are not living at home)

Parent's Phone Number: (if different from above)

EDUCATION AND EMPLOYMENT DETAILS

Last School/College/University Attended:

Examinations/Qualifications Obtained:

How long have you studied English? (not applicable to British Nationals)

Other languages spoken:

Please state whether your knowledge of any other spoken languages is: basic, fair, good, or excellent:

Current Occupation:

Length of notice to be given:

Previous Occupation:

Do you have any other certificates? (certificates of merit, swimming, music, sports, etc.):

If yes, which qualifications do you have?

EXPERIENCE WITH CHILDCARE, HOUSEWORK AND OTHER DETAILS

Please state if you are experienced or comfortable with childcare:

Please state if you are experienced or comfortable with housework:

If you have experience with children can you supply childcare references?

What type of housework have you done in the past?

If yes, please describe your level of expertise, and describe some dishes, etc., you can cook:

If not, from what do you suffer?

If yes, what allergies do you have?

If yes, what were you convicted of?

If no, what do you not eat, or what are your dietary restraints (such as religious restraints)?

If yes, then how many per day?

Which sports do you play?

Do you play a musical instrument? And if so, which instrument?

If yes, which animals do you like?

If yes, please state the date you passed your test:

Please give details of hobbies or interests, and/or any further information that you feel might help us find the right position for you:

DECLARATION

I fully understand the Agency's conditions, and agree to abide by these conditions. Furthermore, all the details given by me on this application form are correct.

I agree to the above declaration (please state that you agree): *

Electronic Signature: (please state your name): *