Client Registration

Parent/Guardian *

First Name

Last Name

Parent/Guardian 1 - Phone *

Country

(###)

###

####

What Type of Services are of interest? *

Maternity Nurse

Nanny

Housekeeping

Other (please specify below)

Type of proposed employment

Temporary

Permanent

Position Start Date *

MM

DD

YYYY

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I accept and agree with the New Mums London Terms & Conditions

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