Belle Casa North Wales - Domestic Cleaning Services


Belle Casa North Wales and Republic of Ireland
offers professional domestic cleaning and
ironing services to private homeowners.

If you would like to become part of our team of Belle Casa cleaners in
North Wales and the Republic of Ireland please fill in the Application Form below.

Please note that all cleaners must follow the Guidelines and Procedures laid down by Bella Casa
North Wales and Republic of Ireland. Please click here to view them.

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Application Form

1) Your details:  
First Name:
Last Name:
Address:
Telephone:
Mobile:
How old are you?
National Insurance Number?

Your Email address?


2) Children:		  
Do you have Children ?:
(Please skip to Section 3 if you do not have children)		 Yes No
-Name of Child 1
-Age of Child 1
- Name of Child 2
- Age of Child 2
Do you have childcare cover? Yes No
Is cover available during school holidays? Yes No


3) General 		 
Do you smoke? Yes No
Do you have any phobias?
(Please list in comments section) 		Yes No
Do you have any ongoing ilnesses
(Please list in comments section)		 Yes No
Do you have any allergies
(Please list in comments section)		 Yes No
Are you able to do ironing? Yes No
Are you on benefits? Yes No


4) Travel and Transport 		 
Do you have a car? Yes No
If you do not have a car,
how far are you prepared to travel?


5) Availability: 		 
When can you start work for Belle Casa?
What days and times are you available to work?
- Mondays?
(Please list times or "all day" or "not available" )
- Tuesdays?
(Please list times or "all day" or "not available" )
- Wednesdays?
(Please list times or "all day" or "not available" )
- Thursdays?
(Please list times or "all day" or "not available" )
- Fridays?
(Please list times or "all day" or "not available" )


6) Social Reference
 (no relatives or close friends)		  
Name:
Address:
Telephone Number:

7) Work Reference
(current or last place of emplyoment) 		 
Name:
Address:
Telephone:


8) Work Experience:
Please list your work experience:


9) Comments:
Please make enter any additional details, including details of phobias or allergies etc.
   
By clicking on the botton below, I declare that the information I have entered on this form is accurate, and if taken on by Belle Casa North Wales I further agree to perform assignments accoring to the Guidelines and Procedures and understand that if it is found that any statement made on this form is untrue then I will immediately be removed from the Belle Casa North Wales list of approved housekeepers.

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