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(Victoria Wide)
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Family Register Your Interest Form
First Name*
Please enter your first name.
Please enter your first name.
Last Name*
Please enter your last name.
Please enter your last name.
Email*
Please enter your email.
Please enter your email.
Personal Details
Home Phone
Field is required!
Field is required!
Mobile Phone*
Please enter your mobile phone number.
Please enter your mobile phone number.
Street Address*
Please enter your street address.
Please enter your street address.
Suburb*
Please enter your suburb.
Please enter your suburb.
Post Code*
Please enter your post code.
Please enter your post code.
State*
- select an option -
VIC
Please select your state.
Please select your state.
How did you hear about us?*
- select an option -
Brochure / Phamplet / Leaflet
Carer
Client
Facebook
Friend
Hospital
IHC
Internet (Google, Yahoo, MSN, Safari)
Kindergarten
Maternal Health Centre
Mothers Group
Obsetrician Gynocologist
Play Centre
School
Shop Front, Walk By
Website
Word of Mouth
Other
Please select an option.
Please select an option.
Parent/Guardian 2
If this is not a single parent household, it is important to fill in all information for your partner.
First Name
Please enter your partner's first name.
Please enter your partner's first name.
Last Name
Please enter your partner's last name.
Please enter your partner's last name.
Mobile Phone
Please enter your partner's mobile phone number.
Please enter your partner's mobile phone number.
Child Information
It is important to fill in all information for all your children.
Child 1
More detailed information (allergies, dietary requirements, hobbies, interests, developmental milestones etc.) will be collected if you register your family.
Please note, if you are registering to find a cleaner/housekeeper and do not have any children, please fill in N/A for First Name, any Gender and today's date for Date of Birth
First Name or due Date*
Please enter your child's first name or due date.
Please enter your child's first name or due date.
Gender*
- select an option -
Female
Male
Please enter your child's gender.
Please enter your child's gender.
Date of Birth*
Day
- enter the day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Please enter your child's date of birth
Please enter your child's date of birth
Month
- enter the month -
January
February
March
April
May
June
July
August
September
October
November
December
Please enter your child's date of birth
Please enter your child's date of birth
Year
Please enter your child's date of birth
Please enter your child's date of birth
Child 2
More detailed information (allergies, dietary requirements, hobbies, interests, developmental milestones etc.) will be collected if you register your family.
First Name or due Date
Please enter your child's first name.
Please enter your child's first name.
Gender
- select an option -
Female
Male
Please enter your child's gender.
Please enter your child's gender.
Date of Birth
Day
- enter the day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Field is required!
Field is required!
Month
- enter the month -
January
February
March
April
May
June
July
August
September
October
November
December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Child 3
More detailed information (allergies, dietary requirements, hobbies, interests, developmental milestones etc.) will be collected if you register your family.
First Name or due Date
Please enter your child's first name.
Please enter your child's first name.
Gender
- select an option -
Female
Male
Please enter your child's gender.
Please enter your child's gender.
Date of Birth
Day
- enter the day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Field is required!
Field is required!
Month
- enter the month -
January
February
March
April
May
June
July
August
September
October
November
December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Child 4
More detailed information (allergies, dietary requirements, hobbies, interests, developmental milestones etc.) will be collected if you register your family.
First Name or due Date
Please enter your child's first name.
Please enter your child's first name.
Gender
- select an option -
Female
Male
Please enter your child's gender.
Please enter your child's gender.
Date of Birth
Day
- enter the day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Field is required!
Field is required!
Month
- enter the month -
January
February
March
April
May
June
July
August
September
October
November
December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Child 5
More detailed information (allergies, dietary requirements, hobbies, interests, developmental milestones etc.) will be collected if you register your family.
First Name or due Date
Please enter your child's first name.
Please enter your child's first name.
Gender
- select an option -
Female
Male
Please enter your child's gender.
Please enter your child's gender.
Date of Birth
Day
- enter the day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Field is required!
Field is required!
Month
- enter the month -
January
February
March
April
May
June
July
August
September
October
November
December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Child 6
More detailed information (allergies, dietary requirements, hobbies, interests, developmental milestones etc.) will be collected if you register your family.
First Name or due Date
Please enter your child's first name.
Please enter your child's first name.
Gender
- select an option -
Female
Male
Please enter your child's gender.
Please enter your child's gender.
Date of Birth
Day
- enter the day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Field is required!
Field is required!
Month
- enter the month -
January
February
March
April
May
June
July
August
September
October
November
December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Child 7
More detailed information (allergies, dietary requirements, hobbies, interests, developmental milestones etc.) will be collected if you register your family.
First Name or due Date
Please enter your child's first name.
Please enter your child's first name.
Gender
- select an option -
Female
Male
Please enter your child's gender.
Please enter your child's gender.
Date of Birth
Day
- enter the day -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Field is required!
Field is required!
Month
- enter the month -
January
February
March
April
May
June
July
August
September
October
November
December
Field is required!
Field is required!
Year
Field is required!
Field is required!
Position Information
What service are you interested in and what rate range would you be willing to pay?*
Service Required*
- select an option -
After/Before School Care
Mothercraft Nurse/Night Nanny
Cleaner
Nanny Day
Nanny/Housekeeper
Housekeeper
Mothers Helper/Junior Nanny
Please select a service.
Please select a service.
Please note, we only register clients who are able to offer the base industry rate or more per hour
The rate range MUST be $40-42 and above for this service type
[{"field":"service_required","logic":"equal","value":"After\/Before School Care","and_method":"or","field_and":"service_required","logic_and":"equal","value_and":"Mothercraft Nurse\/Night Nanny"}]
Please note, we only register clients who are able to offer the base industry rate or more per hour
The rate range MUST be $30-32 and above for this service type
[{"field":"service_required","logic":"equal","value":"Cleaner","and_method":"","field_and":"","logic_and":"","value_and":""}]
Please note, we only register clients who are able to offer the base industry rate or more per hour
The rate range MUST be $32-34 and above for this service type
[{"field":"service_required","logic":"equal","value":"Nanny Day","and_method":"","field_and":"","logic_and":"","value_and":""}]
Please note, we only register clients who are able to offer the base industry rate or more per hour
The rate range MUST be $35-37 and above for this service type
[{"field":"{service_required}","logic":"equal","value":"Nanny\/Housekeeper","and_method":"or","field_and":"{service_required}","logic_and":"equal","value_and":"Housekeeper"}]
Please note, we only register clients who are able to offer the base industry rate or more per hour
The rate range MUST be $28-30 and above for this service type
[{"field":"service_required","logic":"equal","value":"Mothers Helper\/Junior Nanny","and_method":"","field_and":"","logic_and":"","value_and":""}]
Rate Range*
- select an option -
$28-30
$29-31
$30-32
$31-32
$32-34
$33-35
$34-36
$35-37
$36-38
$37-39
$38-40
$39-41
$40-42
$41-43
$42-44
$43-45
$44-46
$45-47
$46-48
$47-49
$48-50
$49-51
$50-52
Please select a rate range.
Please select a rate range.
For ongoing and long term roles, please fill in the information below.
How many days?*
- select a option -
1 day
2 days
3 days
4 days
5 days
6 days
7 days
Please answer the question.
Please answer the question.
... days per*
Note that fortnightly positions rarely have many applicants apply, depending on the industry demand at the time of your enquiry, we may not take fortnightly requests
- select an option -
per week
per fortnight
Please answer the question.
Please answer the question.
Are you flexible with the days required?
The more flexible you are, the wider selection of candidates you will be able to meet.
Yes
No
Please answer the question.
Please answer the question.
If flexible with days, details
Field is required!
Field is required!
Are you flexible with the times required?
Yes
No
Please answer the question.
Please answer the question.
If flexible with times, details
Field is required!
Field is required!
Required Hours*
You must input the hours you require below
Monday
Shift 1 Start Time
Field is required!
Field is required!
Shift 1 Finish Time
Field is required!
Field is required!
Shift 2 Start Time
Field is required!
Field is required!
Shift 2 Finish Time
Field is required!
Field is required!
Tuesday
Shift 1 Start Time
Field is required!
Field is required!
Shift 1 Finish Time
Field is required!
Field is required!
Shift 2 Start Time
Field is required!
Field is required!
Shift 2 Finish Time
Field is required!
Field is required!
Wednesday
Shift 1 Start Time
Field is required!
Field is required!
Shift 1 Finish Time
Field is required!
Field is required!
Shift 2 Start Time
Field is required!
Field is required!
Shift 2 Finish Time
Field is required!
Field is required!
Thursday
Shift 1 Start Time
Field is required!
Field is required!
Shift 1 Finish Time
Field is required!
Field is required!
Shift 2 Start Time
Field is required!
Field is required!
Shift 2 Finish Time
Field is required!
Field is required!
Friday
Shift 1 Start Time
Field is required!
Field is required!
Shift 1 Finish Time
Field is required!
Field is required!
Shift 2 Start Time
Field is required!
Field is required!
Shift 2 Finish Time
Field is required!
Field is required!
Saturday
Shift 1 Start Time
Field is required!
Field is required!
Shift 1 Finish Time
Field is required!
Field is required!
Shift 2 Start Time
Field is required!
Field is required!
Shift 2 Finish Time
Field is required!
Field is required!
Sunday
Shift 1 Start Time
Field is required!
Field is required!
Shift 1 Finish Time
Field is required!
Field is required!
Shift 2 Start Time
Field is required!
Field is required!
Shift 2 Finish Time
Field is required!
Field is required!
Submit
Home
Services
Childcare Services
Household Services
FAQs
Booking
Families Register Here
Methods of Engagement
Permanent Placement
Work Cover
Public Liability Insurance
Pricing
Methods of Engagement
Minumum rates
Cancellation Information
Pricing Table
Permanent Placement
Employment
Jobs of the Week
Carers Register Here
Carer Update Form
The Team
Contact
(03) 9576 7000
(Victoria Wide)
