All fields required, unless stated otherwise.
Full Name
Address (Including Post Code)
Date of Birth
Home Telephone Number
Mobile Telephone Number
Email Address
Do you have a full UK driving licence? YesNo
Do you have use of a car? YesNo
Do you require a work permit? YesNo
If you require a permit, please state the details below. (Otherwise, leave blank)
Do you have a CRB/DBS? YesNo
If yes, please provide CRB/DBS Number
Are you Registered on the DBS Update Service? YesNo
If yes, please provide DBS Update Service Number
Position(s) sought Senior Nursery ManagementNursery ManagerNursery Deputy ManagerNursery Team LeaderNursery Third in ChargeNursery Room LeaderNursery Senior PractitionerNursery PractitionerNursery AssistantNursery Apprentice
Type of work required Full TimePart TimeFull or Part Time
Notice Period
Areas you can work / travel too
Minimum Salary
Note: Please start with your most recent employer, please account for any gaps in your employment in the notes section below.
Current Employer Please state Company Name, your position and a brief description of your role
Previous Employer Number One Please state Company Name, your position and a brief description of your role
Previous Employer Number Two Please state Company Name, your position and a brief description of your role
Employment History Notes (Optional)
State qualifications. Include qualifications gain (GCSE, NNEB,NVQ2/3 etc), also include any qualifications currently being studied. Please state dates. Add all your childcare and relevant qualifications including dates and where obtained.
Give a brief description of your personality?
What are your achievements?
What are your aspirations for the future?
Do you have any medical conditions or Allergies e.g. Asthma, Hayfever, Eip-pen – please give brief details below including any daily medication Note: If you've not had any accidents or illnesses over the past two years, please type 'None' below. Otherwise, please detail accidents/illnesses below.
Absences over the past two years? Please give information on any accidents / illnesses or absences over the last two years including number of days absence. Note: If you've not had any sickness in the past two years, please type 'None' below. Otherwise, please state the amount of days and reasons below.
Have you ever been through formal disciplinary action as a result of your Childcare Practice or Safeguarding Practice? Note: If no, please type 'No' below. If yes, please state details below.
Current Employer (Please state Full Name, Position, Company Name, Telephone Number and Email Address).
Can we contact your Current Employer before the interview? YesNo
Previous Employer (Please state Full Name, Position, Company Name, Telephone Number and Email Address).
Can we contact your Previous Employer before the interview? YesNo
It is important all the information you have supplied is accurate. If you give any information which may be found to be false, misleading or you deliberately omit any relevant information this may lead to your application being rejected, or if you have been appointed, this may lead to your dismissal. You may not be allowed to continue with your registration with us if you fail to produce/hold the original documents.
All information will be kept in accordance with the Data Protection Act. This registration form together with your documents will be retained on our electronic database and from time to time we will contact you with vacancies that are in your areas.
Please tick all the boxes below to complete the Registration form as this will indicate your consent and signature:
I accept: References will be taken and may be passed on to any potential Employers. The checking of information collected with third parties or with other information held by JEM Childcare.
I accept: Information may be passed to certain Third Parties to prevent or detect crime to protect public funds or in any other way permitted or required by law.
I accept: A passport or other document issued by the Home Office which has an endorsement stating that the holder has a current right of residence in the United Kingdom as the family member or a national from a European Economic Area country or Switzerland who is resident in the United Kingdom.
I accept: I confirm that I have completed this Registration Form and confirm that the information herein is true, and that my information will be retained on my electronic personnel file: My CV and Registration form will be used to create my Candidate Profile for prospective Employers. Documentation attached includes electronic copies of my Childcare Qualifications and photo ID (Passport and/or Driving Licence).
Accepted file types are as follows: .jpg .doc .xdoc and .pdf
Please attach the Registration Form
Please attach your completed CV
Please attach your Photo ID, such as a Driving Licence or Passport (Optional)
Please attach your Childcare Certificate (Optional)
Click the SEND button below to send your Registration Form.