Employer Registration Application

What are your requirements?

	Au pair
	Nanny
	Equestrian position - please specify:
	Agricultural position - please specify:
	Other - please specify:

Name:
Address:
Postcode:
Country:
Marital Status:
Age(s):
Home Telephone:
Work Telephone:
Mobile Telephone:
Email:
Nationality:

Description of business:
What are your required Placements Duties?
Is a driving licence essential?	Yes No
Do you provide access to a car?	Yes No
Start date:
Contract period: Long term / Short term / Temporary
Will you accept a candidate from overseas? Yes/No	Yes No
Will you accept smoker? Yes/No	Yes No
Hours of work and state if accomodation provided? (Including facilities)

Please forward your terms and conditions of employment which should include full job description for potential applicants to view.

It will also be helpful if an introduction letter regarding your family and home be mentioned if the applicant is likely to be living with you, especially if they are from overseas. Such details of amenities in your area distance to towns, shops, transport available, etc.

Please supply any other information you think will assist your application:
Are you registered with any other agencies?	Yes No
How did you hear about Language and Leisure?