Registration form for girls

Please fill in our online form to register

Your details:

Title *
First Name *

Surname *

Address *
City *

Post code *
Website

Mobile Number*
Home Number

Email Address *
Resubmit Email Address *

D.O.B.
Nationality *

Religion

How did you hear of Miskin Maternity? *

Your health:

Are you normally in good health?

Do you smoke?

Do you have any children? Do you hold current valid UK working visa?


Your availability:

Do you have any current placements booked?
How many days/nights a week can you work?

Are you happy to travel throughout UK?
Are you happy to travel abroad?


Your skills:

How many babies are you happy to look after? *

Have you cared for premature/ill/special needs babies? *

Your qualifications:

Please upload your current CV and any relevant documents you have available here:


Further training:

We require all our girls to complete foundation breastfeeding training with us, so that we offer consistent, up to date, information tailored to our client’s needs.
Are you willing to train with us?


Your experience

Please provide details of families you have worked for:
Family name
Phone number

Email address
Number of babies

Baby’s age
Length of placement


Family details

Family name
Phone number

Email address
Number of babies

Baby’s age
Length of placement

Family details

Family name
Phone number

Email address
Number of babies

Baby’s age
Length of placement


Additional information

To ensure that we can place you with a suitable family, please would you give us a bit more information about yourself.
Do you have any allergies or medical conditions that may prevent you from being placed with certain families e.g. pet allergies:

Any specific religious requirements:
Any other considerations we have not mentioned?

Please confirm that you are a human by entering the words shown into the box below *
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Please read and confirm the following:

I certify that this information that I have supplied is true and correct and that I accept your Terms and Conditions of business.

I recognise that any information given to me by potential employers or other applicants is highly confidential and will not divulge any information irresponsibly.

I am responsible for my own tax and National Insurance.

I have Professional liability insurance. (If not please speak to us.)

It is understood that any misrepresentation by me on this application form will be sufficient cause for cancellation of this application and/or termination from Miskin Maternity’s service if I have been employed.

I give Miskin Maternity the right to contact pervious employers and secure additional information about me relating to my role.

I hereby release from liability Miskin Maternity and its representatives for seeking such information and all other persons, corporations and organisations for furnishing such information.