HOME
CLIENTS
CANDIDATES
SERVICES
BOOK A SERVICE
TERMS & CONDITIONS
CONTACT US
 
New Client Registration Form - Family

Please spend a few minutes completing our client registration form, as it will help us match a suitable Cleaner to your requirements; all details are of course confidential will used by Gen122 Services solely for this purpose.
Contact Details
First Name
Surname
Address
Postcode
Daytime Telephone (+code)
Evening Telephone (+code)
E-mail address
About your Family
Occupation
Nationality
Religion
Languages spoken
Marital Status
Married Single Other
Do you have any Children
Yes No  
If yes, please specify
Ages & Gender of Children
Do the Children attend School or Nursery?
Yes No  
How far is the School or Nursery from your home?
Do any of the Children stay home all day?
Yes No  
Any other information regarding the children? (special needs, allergies)
Are you expecting a baby?
Yes No  
If yes, please state when?
Do you have any pets
Yes No  
if yes please state which ones?
Does an family member have a criminal
record?
Yes No  
Do you smoke
Yes No  

About your Property

  
Accommodation type
Bungalow Flat House
If a house, please specify
Detached Terraced Semi
Number of Reception rooms
Number of Bedrooms
Number of Bathrooms
Number of Floors
Number of Toilets
Nearest Bus/Tube Station

Services Required

 
Child Care
 
Ironing
 
Washing
Cleaning
 
Cooking
 

About Your Aupair / Nanny 
Length Of Service Required:
6 months 12 months
 
Tick below duties expected of your Aupair:
Cooking Cleaning Ironing
 
Baby Sitting School Run Home Work
 
Do you have a preference for gender?
No Preference Male Female
Age Range
18-24 25-35 35+
Smoking Preference
No Preference Non Smoker Smoker
 
Does the Aupair need driving Skills:
Yes No
 
Will the Aupair have there own Room?
Yes No
 
Tick facilities available to Aupair:
Television Bathroom Radio
 
Use of Computer
Working hours required?
Monday AM PM
Tuesday AM PM
Wednesday AM PM
Thursday AM PM
Friday AM PM
Saturday AM PM
Sunday AM PM
 
Your Target Weekly Pay Rates?
 
Date you want Service to Commence:
 

I have read the Agency’s terms and condition and by submitting this form I agree to this terms and conditions.

 
 
Copyright © Gen122services.com