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 a * are required and must be completed. Please note that this application form is for short term placements of maximum 4 months. If you are looking for a long term candidate please fill in our regular application form

First Name*

Last Name*

Home Tel N° (country code first)

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Work Tel N° (country code first)

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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*

  -- Albania Algeria Andora Argentina Armenia Australia Austria Azerbaijan Bahamas Belarus Belgium Bosnia-Herzegovina Botswana Brazil Bulgaria Cameroun Canada Canary Islands Cayman Islands Chile China Colombia Costa Rica Croatia Cyprus Cezch Rupublic Cezchslovakia Democratic Republic of Congo Denmark Dominician Republic Ecuador Egypt El Salvador Estonia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Holland Honduras Hong Kong Hungary Iceland India Indonesia Iran Ireland Israel Italy Jamaica Japan Jordan Kenya Latvia Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malasyia Malta Mexico Monaco Mongolia Morocco Nambia New Zealand Nigeria Norway Pakistan Panama Peru Phillipines Poland Portugal Romania Russia Salvadore San Marino Seychelles Singapore Slovak Republics Slovenia South Africa South Korea Spain Swaziland Sweden Switzerland Taiwan Tanzania Thailand Togo Trinidad and Tobago Turkey Uganda Ukraine United Kingdom United States of America Unlisted Venezuela Yugoslavia Zambia Zimbabwe

Marital Status*

Nationality*

  -- Albania Algeria Andorra Argentina Armenia Australia Austria Azerbaijan Bahamas Belarus Belgium Bosnia-Herzegovina Botswana Brazil Bulgaria Cameroun Canada Canary Islands Cayman Islands Chile China Colombia Costa Rica Croatia Cyprus Cezch Rupublic Cezchslovakia Democratic Republic of Congo Denmark Dominician Republic Ecuador Egypt El Salvador Estonia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Holland Honduras Hong Kong Hungary Iceland India Indonesia Iran Ireland Israel Italy Jamaica Japan Jordan Kenya Latvia Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malasyia Malta Mexico Monaco Mongolia Morocco Nambia New Zealand Nigeria Norway Pakistan Panama Peru Phillipines Poland Portugal Romania Russia Salvadore San Marino Seychelles Singapore Slovak Republics Slovenia South Africa South Korea Spain Swaziland Sweden Switzerland Taiwan Tanzania Thailand Togo Trinidad and Tobago Turkey Uganda Ukraine United Kingdom United States of America Unlisted Venezuela Yugoslavia Zambia Zimbabwe

Religion

Profession-Husband

Profession-Wife

Languages spoken*

  Press Ctrl to make multiple selections Afrikaans Albanian Algerian Armenian Bulgarian Chinese Cezch Croatian Danish Egyptian English Estonian Finnish Flemish French Georgian German Greek Hebrew Hungarian Indonesian Iranian Italian Jamaican Japanese Lithuanian Macedonian Malasyian Maltese Mongolian Moroccan Nigerian Norwegan Pakistan Peruvian Polish Portugese Romanian Russian Slovakian Slovenian Korean Spanish Swedish Turkish Ukranian

Names and ages of children.*

Description of home and locality * (please state 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?

  Press ctrl to make multiple selections Afrikaans Albanian Algerian Armenian Bulgarian Chinese Cezch Croatian Danish Egyptian English Estonian Finnish Flemish French Georgian German Greek Hebrew Hungarian Indonesian Iranian Italian Jamaican Japanese Lithuanian Macedonian Malasyian Maltese Mongolian Moroccan Nigerian Norwegan Pakistan Peruvian Polish Portugese Romanian Russian Slovakian Slovenian Korean Spanish Swedish Turkish Ukranian

Would you consider employing a male?

Will you give use of a car?

Approx starting date*

  -- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 -- Jun July Aug Sept -- 2011 2012

Length of stay* This application form is for short term stays. If you require a candidate for a longer period please fill in our regular application form

  Length of Stay 1mth 2mths 3mths 4mths

Description of candidate's accommodation*

Approx hrs of work:*

Afternoon from to 

Total daily hours: (max 10 hours per day)*

  -- 1 2 3 4 5 6 7 8 9 10

Duties (please go into as much detail as possible)*

Time off*

  Time Off 1 day 1 1/2 days 2 days Weekends

N° Evenings off (excluding the evenings of the days off)*

Weekly salary*

  -- US Dollar Afghanistan Afghani Albanian Lek Algerian Dinar Andorran Franc Andorran Peseta Angolan New Kwanza Argentine Peso Aruban Florin Australian Dollar Austrian Schilling Bahamanian Dollar Bahraini Dinar Bangladeshi Taka Barbados Dollar Belgian Franc Belize Dollar Bermudian Dollar Bhutan Ngultrum Bolivian Boliviano Botswana Pula Brazilian Real British Pound Brunei Dollar Bulgarian Lev Burundi Franc CFA Franc BCEAO CFA Franc BEAC Cambodian Riel Canadian Dollar Cape Verde Escudo Cayman Islands Dollar Central Pacific Franc Chilean Peso Chinese Yuan Renminbi Colombian Peso Comoros Franc Costa Rican Colon Croatian Kuna Cuban Peso Cyprus Pound Czech Koruna Danish Krone Djibouti Franc Dominican R. Peso Dutch Guilder ECU East Caribbean Dollar Ecuador Sucre Egyptian Pound El Salvador Colon Estonian Kroon Ethiopian Birr Euro Falkland Islands Pound Fiji Dollar Finnish Markka French Franc Gambian Dalasi German Mark Ghanaian Cedi Gibraltar Pound Gold (oz.) Greek Drachma Guatemalan Quetzal Guinea Franc Guyanese Dollar Haitian Gourde Honduran Lempira Hong Kong Dollar Hungarian Forint Iceland Krona Indian Rupee Indonesian Rupiah Iranian Rial Iraqi Dinar Irish Punt Israeli New Shekel Italian Lira Jamaican Dollar Japanese Yen Jordanian Dinar Kazakhstan Tenge Kenyan Shilling Kuwaiti Dinar Lao Kip Latvian Lats Lebanese Pound Lesotho Loti Liberian Dollar Libyan Dinar Lithuanian Litas Luxembourg Franc Macau Pataca Malagasy Franc Malawi Kwacha Malaysian Ringgit Maldive Rufiyaa Maltese Lira Mauritanian Ouguiya Mauritius Rupee Mexican Peso Mongolian Tugrik Moroccan Dirham Mozambique Metical Myanmar Kyat NL Antillian Guilder Namibia Dollar Nepalese Rupee New Zealand Dollar Nicaraguan Cordoba Oro Nigerian Naira North Korean Won Norwegian Kroner Omani Rial Pakistan Rupee Palladium (oz.) Panamanian Balboa Papua New Guinea Kina Paraguay Guarani Peruvian Nuevo Sol Philippine Peso Platinum (oz.) Polish Zloty Portuguese Escudo Qatari Rial Romanian Leu Russian Rouble Samoan Tala Sao Tome/Principe Dobra Saudi Riyal Seychelles Rupee Sierra Leone Leone Silver (oz.) Singapore Dollar Slovak Koruna Slovenian Tolar Solomon Islands Dollar Somali Shilling South African Rand South-Korean Won Spanish Peseta Sri Lanka Rupee St. Helena Pound Sudanese Dinar Sudanese Pound Suriname Guilder Swaziland Lilangeni Swedish Krona Swiss Franc Syrian Pound Taiwan Dollar Tanzanian Shilling Thai Baht Tonga Pa'anga Trinidad/Tobago Dollar Tunisian Dinar Turkish Lira Uganda Shilling Ukraine Hryvnia Uruguayan Peso Utd. Arab Emir. Dirham Vanuatu Vatu Venezuelan Bolivar Vietnamese Dong Yugoslav Dinar Zambian Kwacha Zimbabwe Dollar

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? *

  -- Ask Jeeves Aupairsearch E-mail Google Lycos MsnSearch NannyJobUK Other Other Search Engine Word of mouth Yahoo

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.

 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 of £550.00 3. 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 3rd parties. 4. Personal contacts or interviews with prospective candidates or their acquaintances can be arranged only if the full Placement Fee has been preauthorized by credit or debit card. After preauthorization has been received the Client will receive the candidate’s contact details and will have 7 days in which to decide whether to hire the candidate or not. After 7 days the Client’s credit or debit card will be charged unless the Client contacts the Agency to inform it that they do not want to confirm the candidate. Subsequently if the Client decides not to confirm the candidate the card will be refunded in full. When the Client receives an offer of a candidate and clinks on the link to confirm the candidate the Client authorizes the Agency to debit their debit or credit card with the Placement Fee as per the Agency’s invoice in order to confirm the candidate. When the Client receives an offer of a candidate and clicks on the link requesting further information on the candidate they are requesting the candidates contact details to contact the candidate directly and subsequently are authorizing the Agency to preauthorize their debit or credit card with the Placement Fee as per the Agency’s invoice. 5. If the Client directly contacts a candidate introduced by the Agency without the Agency’s authorization the Client will be in breach of these terms and conditions and the Agency reserves the right to suspend the search on the Client’s behalf and the registration will be considered invalidated and non refundable. 6. Should the client effect any form of introduction, direct or indirect, of a candidate 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 Placement Fee in accordance to the Current Scale of Charges. 7. The Agency will endeavour to provide the Client with candidates as well suited as possible, and to this end will seek to furnish the Client with all relevant information concerning the candidate and to check details, documentation and references. However, the final responsibility for any decision to employ the candidate 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 candidate. 8. The Agency accepts no liability of any kind for any inconvenience , loss or damage to property, or any loss or injury howsoever arising directly or indirectly from any act of omission of any candidate introduced by the Agency even if such act of omission is negligent or fraudulent or reveals dishonesty. 9. 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 Placement Fee as stated on the Agency’s invoice sent to the Client prior to the arrival of the candidate. Fees are inclusive of all expenses. 10. In the event that a candidate should cancel her 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 placement, prior to the commencement date a replacement candidate will be provided at a later date free of charge. Under no circumstances is the Placement Fee refundable once the Client and candidate have sent the Final Acceptance e-mail. 11. The duration of the contract is specified on the job description established by the Client on the application form. Once the candidate has completed the duration of contract she/he has completed his/her contract and will be eligible for placement in a new host family. If the Client and candidate want to renew the contract for a further period, short or long term, this needs to be done through the Agency and a subsequent Placement Fee will be due at a 50% reduced rate as per the Agency’s scale of charges. If the Client does not contact the Agency to inform it that the contract has been terminated the contract will be automatically renewed for a subsequent period equal to that of the initial contract period and the Client’s credit or debit card will be charged with the subsequent fees due. 12. If a candidate employed by the Client through the Agency is re-employed by the Client after the termination of the original period of employment then a further Placement Fee shall be payable by the Client to the Agency. Such Placement Fee will be equivalent to the Placement Fee which would have been payable by the Client to the Agency if the Agency would have introduced the candidate to the Client at time of re-employment reduced by 50%. 13. In the event that a candidate introduced by the Agency is dismissed by the Client within 6 weeks of engagement, or if the candidate leaves of his/her accord within that period, the Agency must be notified within the first 6 weeks of engagement in writing. 14. On receipt of the candidate’s and Client’s confirmation that he/she has left employment of the Client within 6 week’s of the commencement of employment, a substitute will be supplied after payment of the flight contribution (see point 15) and without any further charges. 15. Together with the Placement Fee, on confirmation a flight contribution of £120.00 is due to cover the flight contribution the host family will pay the candidate on completion of her contract. The Agency will refund this sum to the Client once the candidate has completed her contract. 16. On the candidate arrives in the Client's home the Client must deduct £120.00 for the candidate's first salary and refund ths to the candidate if she stays at least 6 weeks in her contract. 17. After the agreed duration, the candidate is entitled to recieve from the Client a flight contribution of £120.00 and paid holidays. After a one year stay one month’s paid holiday is due. Shorter durations are calculated pro-rata. 18. 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. During the whole notice period the candidate is required to carry out her normal duties and be paid the agreed salary. 19. The Agency does not employ the candidates introduced and any Contracts of Employment entered into between the Client and the candidate 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. 20. If the candidate is unable to perform her duties due to sickness or injury she shall be entitled to receive sick leave in accordance with the following: Full pay for the first week. Half pay for the second week. If the candidate ‘s absence exceeds 2 weeks any further payments will be at the discretion of the Client and in addition the Client shall be entitled to terminate the appointment in accordance with the notice period. 21. The Agency cannot guarantee that a candidate will complete his/her proposed length of stay or engagement. 22. No replacement candidate or further 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. 23. 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. 24. On application a £99.00 deposit is payable. The deposit is valid for one year and will bed deducted from the placement fee on confirmation. The deposit is not refundable. 25. The Client and candidate 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 responsibility if this information is incorrect as this type of information is subject to frequent change. 26. On acceptance of these terms and conditions the Clients confirms that they are already receiving the services of the Agency and authorize the Agency to post their offer on totalnannies.com and carry out the recruitment of suitable candidates on their behalf. 27. English law will be applied to this contract and both parties agree to submit jurisdiction of English courts of law. 28. We reserve the right to withdraw our services and terminate the agreement at any time and in this case all payments will be refunded in full.