Register with Totos

Please take a few minutes to complete as much of the form as you can.

A little bit about you...
Your name*
Gender*	Female Male
Age*
Date of Birth
Height (m)
Weight (kg)
Nationality*
Passport Number
Passport Expiry Date
Contact details
Address*
Home tel*
Work tel
Mobile tel
Fax number
Email*
Placement details
What is the latest date that you can start?
What date do you wish to start your placement?
How long do you wish to stay for? (Months)
Family details
Father's Occupation
Mothers' Occupation
Brothers' Ages
Sisters' Ages
Education
Please give a brief description of your education, the subjects you have studied and enjoyed, your qualifications and any other information you consider relevant.
Type here...
How many years have you studied English?
What is your level of spoken English?
Which other languages do you speak?
Do you wish to attend English classes?	Yes No
Childcare and Family Home Experience
Please describe what you have done for the last 3 years and your childcare experience.
Details here..
Would you consider a family with ...	0 children? 1-3 children? 4+ children?
Would you consider a family with ...	0-1 years old 1-3 years old 4-7 years old 7+ years old
Would you consider a single ...	Mother Father
Driving
Do you have a driving licence?	Yes No
Will you drive in the UK?	Yes No
Health
Do you smoke?	Yes No
If 'Yes', how many per day??
If you smoke, would you be prepared to not smoke in the family home?	Yes No
Do you have any illnesses or injuries?	Yes No
If 'Yes', could you please give details
Will you go to a family with cats and dogs?	Yes No
Do you have any allergies?	Yes No
If 'Yes', could you please give details
Are you a vegetarian?	Yes No
Would you accept a non-vegetarian family?	Yes No
Can you swim?	Yes No
Work duties
Are you able to carry out the following duties?
Tick all that apply	Washing & Ironing Dusting & Vacuuming General Tidying Cooking Sole Charge Cooking Assistance Driving
Area Preferences
Would you accept a position in ...	the country a (small) town? a (large) city?
Would you prefer to be in a specific area?	Yes No
If 'Yes', please give details
Previous travel
Have you traveled to other countries before?	Yes No
If 'Yes', please give details
Have you lived away from home before?	Yes No
If 'Yes', please give details
Have you been to, or are you in, the UK?	Yes No
If 'Yes', please give details
Other interests
Could you please describe your other interests and hobbies.
Other information
Do you have any visible tattoos or body piercings?	Yes No
If 'Yes', please give details
Do you have a Criminal record?	Yes No
If 'Yes', please give details

VERY IMPORTANT
The information you have given us here will help us match you to a suitable family. Before we will be able to match you with a family, we will also need you to send us by post: a doctor's certificate of good health 2 references from people that you have worked for, from a family who's children you have cared for, or a former teacher. a letter of introduction about yourself to the family, including your hobbies and your background. 4 passport size photographs with your name on the reverse. Police check.
	* denotes required field

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