Buttons Nanny Agency Surrey and West London clients application form

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Clients Application

Please check that you reside within (or near to) our areas:

Surrey & Wimbledon SW18 & SW19 Branch
West London & Harrow Branch

Please fill in our Employers Form

If you would like to print this form and either fax or mail it to us click here

Title
If other please state
First Name
Last Name
Address
Street
Town
County
Postcode
Tel. Mobile
Tel. Home (inc STD code)
Tel. Work (inc STD code)
Fax No.
Email Address * required field
Type of Daily Nanny Required	Full Time Daily Part Time Permanent Temporary Sole Charge Not Sole Charge Driver Essential Driver Not Important
Nursery Duties	Yes No
Would you consider a qualified nanny accompianied by their own child?	Yes No Possibly This arrangement is not suitable for all options & depends on the ages and number of children in the nanny’s care
Are there any dietary requirements?
Duration of booking if temp
If part time, please specify the number of days required	Number of days required
If part time, please specify any particular days of the week that are essential
Are there any home workers or adults in the house during the daytime?	Yes No
If yes, please provide details
Nanny car provided for use at work	Yes No
Nanny car to take home	Yes No
Car owner essential (mileage paid)	Yes No
Number of children
Names and Ages of children at commencement (please indicate M male of F female)
Schools and nursery attended by the children
Childrens hobbies, interests and activities
Is there a new baby expected	Yes No
Date Nanny required from
Could you wait for the right candidate to give 1 months notice	Yes No
Hours of work required
Rates of pay £	Minimum Maximum Per Month Per Week Nett Gross
No. of weeks paid holidays (min 4) please give details
Have you had a nanny before	Yes No
Is other help kept	Yes No
If yes please give details
Clients Occupation	Male Female
Do you have any pets?	Yes No
If so please give details.
Nationality
Religion
How did you hear about Buttons?
If you heard of the agency via the internet please give details of website name or search engine name
Keywords entered for search engine
Additional Information
I have read and agree with Buttons Nanny Agency's Terms of Business

Submit this form to Please submit Wimbledon SW19/20 to Surrey Branch

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