Please fill it in as accurately as possible in order to find you an employee according to your requirements.
First Name: (required)
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Last Name: (required)
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Match your required staff(s): * (required)






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E-mail: (required)
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Street Address:
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Address Line 2
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City: (required)
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State / Province / Region:
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Postal / Zip Code:
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Country:
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Phone Number (Home):
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Mobile Phone Number: (required)
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Nationality:
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Religion:
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Are you a one parent family?
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Language spoken at home:
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Pets:
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Which of these helpers have you employed before:








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Details about your children/senior - Age, Sex, Name:
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Do you expect a new born baby?
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Do you have disabled children?
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Number of bedrooms:
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Do you have a garden?
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Requested start date: * (required)
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How long do you require them to stay? * (required)
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Working time:
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Nationalities preferred:
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Age preferred:
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Would you consider male staff? * (required)
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Should your staff hold a driving license?
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Should your staff have any special skills?
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Would the staff be expected to have sole charge of the children?
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Week salary:
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Will you pay for transport costs?
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Will you pay for health insurance costs?
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If partly... How much?
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Will you pay for English courses?
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If partly… How much?
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Number of work days per week:
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Work hours per day: * (required)
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Will he/she be free at the weekend?
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Number of evenings baby sitting each week:
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Job description: * (required)
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Will the applicant have their own room? * (required)
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Will the applicant have their own bathroom?
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Will the applicant have access to the internet?
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Will the applicant travel with you during your holidays?
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Will the applicant travel with you abroad?
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Other comments which assist us in finding the right applicant for you:
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Photo of family
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Where did you hear about GrapeCare?
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I agree to the scale of charges and Terms and Conditions: (required)
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