| Sure Name: * |
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| First Name: * |
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| Street / No.: * |
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| ZIP Code / City: * |
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| Birthday: * |
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| Telephone / Mobile: * |
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| e-Mail: * |
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| Smoker: * |
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| Driving license: * |
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| Languages: |
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| Do you have experience with child care: * |
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| Education / Profession: * |
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| Experience with...: * |
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| First Aid education for kids: * |
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| Police clearance certificate: * |
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| Health certificate: * |
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| Earliest start of work: * |
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| Work Time: * |
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| Working Hours: |
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| Are you willing to work at the weekend?: * |
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| How many children would you like to take care: * |
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| Which region suite you?: * |
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| Attachments: |
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| For the completeness and correctness of the information: * |
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