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Registration Form for potential housekeeper / domestic cleaner / carer

PLEASE FILL OUT THE FORM BELOW

Name * * Required
Email * * Required * Invalid Address
Tel * * Required
Mobile * * Required
Address * * Required
Date of Birth   (dd/mm/yyyy)
Marital Status
Number of Dependents

Available from?
Until?

Do you drive? yesno
Do you own a car? yesno
Do you smoke? yesno

Current Employment:

Looking for live in? yesno
Looking for live out? yesno

Availability (times):

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Experience with any of the following?:

Light Housework yesno
Heavy Cleaning yesno
Laundry yesno
Ironing yesno
Cooking yesno
Childcare yesno
Silver Cleaning yesno
Carpet Cleaning yesno
Caring for the Elderly yesno
Please give details:

Upload your CV in Word of PDF Format:

I have read, understood and agreed to the Terms and Conditions
* You need to agree to the Terms and Conditions
 

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