Client Registration Form
The Manchester Childcare Company
Parent/ Carer Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Post code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Help Needed?
*
Daily Nanny
Wedding Childcare
Babysitter
After School Nanny
Maternity Nanny
Night Nanny
Weekend Nanny
Mother's Help
School Holiday Nanny
Job Type
*
Permanent
Temporary
Start Date
*
-
Month
-
Day
Year
Date
Number of Children in household
*
Any additional Duties
*
Any Special Dietary Requirements, Eg, Halal, Kosha
*
Brief Description of Family Values and Lifestyle
*
Required days and hours for your nanny?
Will you require a driver?
*
Yes
No
How did you hear about us? If recommendation, by whom?
*
Would you be interested in joining our babysitting membership options?
*
Yes
No
Marketing and Notification Preferences
Text
Email
Submit
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