Nanny Membership Application - Australian Nanny Association (Page 3 of 6) in pdf

Nanny Membership Application - Australian Nanny Association Page 3

NANNY MEMBERSHIP APPLICATION FORM

NANNY APPLICANT TO COMPLETE THIS SECTION

[Full name of applicant]

[Address]

Date of birth

Contact phone number

Email address

Nanny employment status

(e.g. full time - nanny share)

For your nanny membership to be approved please provide us with the following details:

• Working with children check/clearance information

Type of card, state/territory provider

(e.g. WWCC, VIC / Blue card,QLD)

Name on card

_____________

Card number

Card Expiry

If an agency or employer has obtained your working with children clearance please

provide their details.

Name of provider/issuer or holder:

Telephone number:

• First aid details

Name and code of first aid course:

(e.g. Level 2 first aid HLTFA311A)

Name of provider:

Date of issue

• CPR details

Name and code of CPR course:

(e.g. How to perform CPR HLTCPR201B)

Name of provider:

Date of issue

AUSTRALIAN NANNY ASSOCIATION – NANNY MEMBERSHIP APPLICATION /COC – 21/07/14

Nanny Membership Application - Australian Nanny Association Page 3