Vacancies

 

Please note that this form will be presented to prospective families and will be the first impression the family will have of you.
Please answer and fill in as much detail as possible.

Full Name:
Maiden Name:
Date of Birth:
Address Line 1:
Address Line 2:
Town/City:
County:
Post Code:
Day Time Telephone:
Evening Telephone:
E-mail address:
Marital Status:
Are you a smoker:
Would you object to working with smokers
 Yes No
Are you or anyone in your household a smoker
 Yes No
 

Please note that prior to any offers of employment are made it will be required to complete an enhanced CRB disclosure. (Details can be found at http://www.crb.gov.uk/ )

Nationality:
Would you object to sleeping in the same room as the children?
Yes No
Do you mind working for a family with pets?
Yes No
If yes specify which animals?
Have you had a police check in the past 2 years?
Yes No
If yes when was this carried out?
Do you have a criminal record?
 Yes No
If yes please give details:
Are you fit and in good health?
Yes No
In the last year how many sick days have you taken off work?
How far are you willing to travel to work?
 miles
Are you willing to work weekends?
 Yes No
Do you wish to be added to our babysitting register?
 Yes No
Do you have children of your own?
Yes No
If yes, do you need to take your children to work with you?
Yes No
Do you drive?
Yes No
Do you own your own car?
Yes No
Can you cook?
Yes No
Can you swim?
Yes No
Are you first aid trained?
Yes No
Date qualified:
   
  Relevant Education
Name of college:
Address of College:
Dates of attendance:
From: To:
Name of course:
Please list the qualifications gained:
   
  Employment History
  Please give details of your current employer and your reason for leaving
Employer’s name:
Address Line 1:
Address Line 2:
Town/City:
County:
Post Code:
Reason for leaving
  Please give details of your last two jobs and a brief description of your role
  Employer 1
Employer’s name:
Address Line 1:
Address Line 2:
Town/City:
County:
Post Code:
  From: To:
Salary:
Ages of children:
Number of children in your care:
Reason for leaving:
Job description:
   
   
  Employer 2
Employer’s name:
Address Line 1:
Address Line 2:
Town/City:
County:
Post Code:
  From: To:
Salary:
Ages of children:
Number of children in your care:
Reason for leaving:
Job description:
   
  Reference
  Please give the names and address’ of two references, one of which must be a recent employer (please note all references will be taken up)
Address Line 1:
Address Line 2:
Town/City:
County:
Post Code:
Relationship to this person:
Can we contact this person now:
 Yes No
   
Address Line 1:
Address Line 2:
Town/City:
County:
Post Code:
Relationship to this person:
Can we contact this person now:
 Yes No
And finally, how did you hear about us?
   

Declaration:

I declare that all the information supplied is true and correct to the best of my knowledge. If I am offered any employment through this agency I agree to inform the agency immediately. 		Yes, I confirm
Date
Print Name
 

Please feel free to contact us if you have any further queries on
Tel: 01234 325326
Fax: 01234 325326
e-mail: Lesley@hush-a-bye-babies.co.uk
   
 

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