Online Registration

First Name: *

Last Name: *

Telephone Number:

Fax Number:

Email Address: *

Street:

City:

Province:

Postal Code:

Please check if you're willing to be a caregiver on the following areas:

Child Care

Geriatric (Elderly Care)

Special Needs & Physically Challenged

Have you attended any formal caregiver training? :

Yes

Have you worked as a nanny before?:

Yes

If Yes, what Country?:

How many children did you take care of?:

Please describe your duties as a nanny/caregiver from that past work experience:

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