Full Name of Child *
Date of Birth *
Gender * Please selectMaleFemalePrefer not to say
Full Name *
Relationship to Child *
Contact Number *
Email Address *
Home Address *
Preferred Start Date *
Requested Days * MondayTuesdayWednesdayThursdayFriday
Requested Times *
Funding Entitlement Not Sure / Please AdviseWorking Families – 9 Months to 2 YearsWorking Families – 2 Years+2 Year Old Support Funding3 & 4 Year Old – 15 Hours3 & 4 Year Old – 30 Hours
Advertising BannerWord of MouthOnlineOther
If Other, please tell us
Additional Information
I agree that Puddleducks Nurseries may use the information provided in this form to respond to my childcare enquiry.
What Position Are You Looking For? *
Qualifications *
Address *
Are You Looking for Full-Time or Part-Time Work? * Full TimePart Time
If Part-Time, What Days / Hours Are You Available?
Anything Else?
I agree that Puddle Duck Nurseries may use the information provided to contact me regarding employment opportunities.
