Application Form

Host Family's Application Form

SUMMARY

SECTION 1. FAMILY DETAILS

INSTRUCTIONS:

Fill in the application form on-line. Please answer all questions

giving as much detail as possible on your family and your requirements. All fields marked with an * are required and must be completed.

Once your application has been received you will be given a

reference N° that you will need to quote on all correspondence, e-mails or when contacting us by telephone

We offer SSL on-line secure credit card payment and accept all major credit cards. For your convenience if

you prefer, you can fax us your application with your credit card details. We also accept payment by cheque and bank transfers.

First Name*
Last Name*
Home Tel N° (country code first)	-
Work Tel N° (country code first)	-
Mobile Tel N° (country code first)	-
Fax N° (country code first)	-
E-mail
Address Line 1*
Address Line2
City*
County/State*
Zip/Postal Code*
Country*
Marital Status*
Nationality*
Religion
Profession-Husband
Profession-Wife
Languages spoken
Names and ages of children.* Please specify the school hours of the children. When they start school, when they finish school and if the girl needs to take the children to school and go and pick them up. Please also state the distance of the school to your home and with what form of transport will the girl have to go to the children’s school
Description of home and locality* (please state the nearest large town, if in a rural area and if so access to public transport)
Other help kept in home
N° of hours worked weekly of other help
Type of help needed (Please tick)*

Is it ESSENTIAL that the candidate can:
Cook?
Swim?
Drive?
Is a non-smoker?
Has experience with children?
Is mother tongue English?
Will the candidate be expected to do housework for the family?
Does your family have any special needs (please give details)
Will you accept a candidate who smokes only outside?
Do you need a candidate that can speak a particular foreign language?
Would you consider employing a male?
Will you give use of a car?
Approx starting date*
Length of stay*(stays of 1-4 mths are only for maternity nurse placements. For summer stays refer to our short term application form)
If no candidate was available for 1 year would you take someone for 6 mths?
Description of candidate's accommodation. (Own private bedroom should be provided)*
Approx hrs of work:*	Morning from to Afternoon from to
Total daily hours: (max 10 hours per day)*
Duties (please go into as much detail as possible)*
Time off*
N° Evenings off (exlcuding the evenings of the days off)*
Weekly salary*
Is salary negotiable?
Family’s interests*
Where do you go on holiday?*
Do you have any animals?(please give details)*
How did you find our web site? *
If you stated other above please specify (quote ref no if applicable)
Any other relevant information which you feel is important
If you have browsed our summary of available candidates and have seen one or more candidates you are interested in quote their ref N° here
If you have already been registered with us please quote your previous Family Ref N° here.

Terms and Conditions TERMS AND CONDITIONS 1. These Terms and Conditions shall represent a legally binding contract between Totalnannies Ltd (“the Agency”) and the client or employer (“the Client”). 2. The current scale of charges are as follows: placement fee equivalent to one month’s salary offered to the candidate. There is a minimum placement fee of £330.00 3. The verbal or written instruction of the Agency by the Client, or the Client’s appointed agent, to submit suitable applicants for employment, shall constitute acceptance of the Agency’s Terms and Conditions. 4. All correspondence and records shall be confidential and remain the property of the Agency. Information supplied by the Agency is confidential and is accepted by the Client on the condition that such information will not be disclosed to third parties. 5. Once a Client receives an offer of a candidate/s and confirms their interest in the candidate/s the Agency will preauthorize the Client's debit or credit card with the agency fees and provide the Client with the candidate's/s contact details. After preauthorization has been recieved the Client will have 7 days in which to decide whether to hire any of the candidates contacted or not. If the Client does not contact the agency within 7 days to inform it of their decision, it will be presumed that the Client wishes to hire the candidate and their debit or credit card will be charged. On confirmation of a candidate the Client's card will be debited as per the Agency's invoice sent to the Client. If no engagement ensues the credit or debit card will not be charged. Personal contacts or interviews with prospective candidates or their acquaintances can be arranged only if the full Agency Fee has been preauthorized by debit or credit card. The Client, on acceptance of these terms and conditions, authorizes the Agency to preauthorize the Client's debit or credit card with the Agency fees and debit the card if a candidate is confirmed. 6.Should a client effect any form of introduction, direct or indirect, of an applicant to a Third party, or pass on any details resulting in permanent, short-term, full or part-time employment, the Client will be responsible for the full introductory fees in accordance with the current Scale of Charges. 7. The Agency endeavours to provide the Client with applicants as well suited as possible, and to this end will seek to furnish the Client with all relevant information concerning the applicant and to check details, documentation and references. However, the final responsibility for any decision to employ the applicant rests with the Client, who is therefore strongly advised to check details, documentation and references personally. The Agency does not offer any warranty as the suitability, honesty, character or capability of any applicant. 8. The Agency accepts no liability of any kind for any inconvenience, loss or damage of property, or any loss or injury howsoever arising directly or indirectly form any act of omission of any applicant introduced by the Agency even if such act of omission is negligent or fraudulent or reveals dishonesty. 9. The Client agrees to notify the Agency immediately an applicant has accepted an engagement and to supply details to the Agency of the date of commencement and length of employment (when appropriate) and agreed wages (when appropriate). 10. Fees are due on confirmation of a candidate either verbally or in writing, and not at the commencement of employment. The Client shall be liable to pay the Agency’s introduction fees as stated on the Agency’s invoice sent to the Client prior to the arrival of the candidate. Fees are inclusive of all expenses excluding telephone and telefax expenses, which will be charged extra. 11. In the event that an applicant should cancel an agreed engagement prior to the commencement date the Agency will provide a substitute candidate of equivalent qualifications free of charge. Confirmation cannot be tied to only one candidate. In the event that a Client cancels an agreed arrangement, prior to the commencement date, a replacement candidate will be provided at a later date free of charge. Under no circumstances is the agency fee refundable once the Client and candidate have confirmed placement. 12. In the event that an applicant introduced by the Agency is dismissed by the Client within 6 weeks of engagement, or if the applicant leaves of his/her own accord within that period, the Agency must be notified within 5 days of the date, or prospective date of leaving. 13. On receipt of the applicant’s and Client’s confirmation that he or she has left employment of the Client within 6 weeks of the commencement of employment, a substitute candidate will be supplied after payment of the substitution deposit (see point 14) and without any further expense. 14. Together with the agency fee, on confirmation, a substitution deposit of £99.00 is due to cover the expense of substituting a candidate if necessary. The Client deducts this substitution deposit from the candidate’s first salary after arrival. 15. After the agreed duration, the candidate is entitled to have her return fare to London paid for by the Client, or cash equivalent and paid holidays. After a one-year stay one month’s paid holiday is due. Shorter durations are calculated pro rata. 16. Two week’s notice is required by both parties to terminate the engagement. If two week’s notice is not given the candidate is entitled to two week’s extra pay. 17. For applications from male one-parent families two written references need to be supplied from a professional person (lawyer, doctor, accountant etc). 18. The Agency does not employ the applicants introduced and any Contracts of Employment entered into between the Client and the applicant are between those persons directly. The Client is responsible for complying with all employment, fiscal and other relevant legislation, particularly including that related to PAYE and National Insurance when necessary. 19. The Agency cannot guarantee that an applicant will complete his or her proposed length of stay or engagement. 20. No replacement candidate or future discounts will apply if the Client has been in breach of any of the Agency’s Terms and Conditions. Neither will any replacement or discount apply if the Client changes the specifications of the position after the original offer has been made. 21. No replacement candidate or future discounts will apply if statements in the application form prove untrue and/or the conditions undertaken are not kept to. 22. On application a registration fee of £99.00 is payable. This registration fee is valid for one year. The registration fee is not refundable. 23. The Agency confirms that £5.00 of every registration and agency fee will be donated to a children’s charity. 24. The Client and applicant are responsible to obtain all necessary work permits or visas where necessary and is not the responsibility of the Agency. Any information provided by the Agency regarding visas and work permits is purely for informational purposes and the Agency cannot accept responsibilty if this information is incorrect as this type of information is subject to frequent change. I declare to having read and accepted these terms and conditions
I agree to be bound by totalnannies.com's terms and conditions and by the program's regulations