Application

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#FFFF99" TEXT="#080000" background="07e78783.jpg"> <div> <FONT SIZE="5" COLOR="#3333FF" FACE="Book Antiqua" ><B>MOTHERS HELP & BABY - SITTING</B></FONT><FONT SIZE="1" COLOR="#000000" FACE="Book Antiqua" ><B>  </B></FONT><B>  </B><B> </B><FONT SIZE="1" COLOR="#3333FF" FACE="Arial" ><B>| </B></FONT><FONT SIZE="1" COLOR="#3333FF" FACE="Book Antiqua" ><B>    </B><A HREF="index.htm" TARGET="_top" TITLE="MOTHERS HELP BABY SITTING"><U><B>home</B></U></A></FONT></div> <div> <A HREF="services_we_offer_nanny_london.htm" TARGET="_top" TITLE="Services we offer"><U><B>Services we offer</B></U></A><B> |</B><A HREF="application_nanny_in_london.htm" TARGET="_top" TITLE="Application"><U><B>Application</B></U></A><B>  |</B><A HREF="advices_nanny_london.htm" TARGET="_top" TITLE="Advices"><U><B>Advices</B></U></A><B>| </B><A HREF="terms_and_conditions_nanny_london.htm" TARGET="_top" TITLE="Terms and conditions"><U><B>Terms and conditions</B></U></A><B> </B><B>|</B><A HREF="price_list_nanny_london.htm" TARGET="_top" TITLE="Price list"><U><B>Price list</B></U></A><B>| </B><A HREF="vacancies_nanny_london.htm" TARGET="_top" TITLE="vacancies"><U><B>Vacancies</B></U></A><B>| </B><A HREF="areas_we_cover_nanny_london.htm" TARGET="_top" TITLE="Areas we cover"><U><B>Areas we cover</B></U></A><B>  | </B><A HREF="about_us_nanny_london.htm" TARGET="_top" TITLE="About us"><U><B>About us</B></U></A><B> | </B><A HREF="contact_us_nanny_london.htm" TARGET="_top" TITLE="Contact us"><U><B>Contact us</B></U></A><B> | </B></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#CCCCFF" TEXT="#080000"> <bR> <div> <IMG SRC="099bfbf0.jpg" border=0 width="191" height="191" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <div> <B>SERVICES:</B></div> <bR> <bR> <div> <A HREF="mothers_help_in_london.htm" TARGET="_top" TITLE="Mothers Help"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Mothers Help</B></U></A><B> </B></div> <div> <A HREF="part_time_nanny_in_london.htm" TARGET="_top" TITLE="Parttime Nanny"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Part - time Nanny</B></U></A></div> <div> <A HREF="full_time_nanny_in_london.htm" TARGET="_top" TITLE="Full time Nanny"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Full time Nanny</B></U></A></div> <div> <A HREF="housekeeper_in_london.htm" TARGET="_top" TITLE="Housekeeper"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Housekeeper</B></U></A></div> <div> <A HREF="homework_supervision_in_london.htm" TARGET="_top" TITLE="Homework Supervision"><U><B><IMG BORDER="0" SRC="Symb075c00b700dc00000000.png" HEIGHT="15" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Homework Supervision</B></U></A></div> <div> <A HREF="au_pair_in_london.htm" TARGET="_top" TITLE="Au pair"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Au Pa</B></U></A><A HREF="au_pair_in_london.htm" TARGET="_top" TITLE="Au pair"><U><B>ir</B></U></A></div> <div> <A HREF="arrange_a_free_visit_in_london.htm" TARGET="_top" TITLE="Arrange a free visit"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Arrange a FREE visit</B></U></A></div> <div> <A HREF="cleaning_services_in_london.htm" TARGET="_top" TITLE="Cleaning services"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Cleaning services</B></U></A></div> <div> <A HREF="reception____bar_anapest__in_london.htm" TARGET="_top" TITLE="Reception (bar/anapest)"><U><B><IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Book a Assistant</B></U></A></div> <bR> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> E&D Cleaning & Mothers Help</div> <div> "Merlin House"</div> <div> 122-126 Kilburn High Road</div> <div> London</div> <div> NW6 4HY</div> <bR> <div> <IMG SRC="0f3b85c0.jpg" border=0 width="184" height="92" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="06600c00egerdp.jpg"> <bR> <div> <B>"Our kids are everything we have. The most important thing is in which hands they will stay when we need help to look after them."</B></div> <div>     </div> <bR> <div> <TABLE BORDER="2" CELLPADDING="2" CELLSPACING="1" WIDTH="833" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 671 WIDTH="821"><div>  </div> <bR> <div> Please, Fill in the form below:</div> <bR> <bR> <div>  <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="Name,Children Name & Age,Email,City,Post Code,Phone,Comments,Mobile"><input type="hidden" name="tlx_FormIndex" value="1"><input type="hidden" name="tlx_OKMessage" value="Thank you for your comments on my web site."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A comment form was submitted"><input type="hidden" name="tlx_EmailTo" value="info@motherhelp.co.uk"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Name:<br> <input type="text" name="Name" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Children Name & Age:<br> <input type="text" name="Children Name & Age" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Post Code:<br> <input type="text" name="Post Code" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Comments:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="left">Mobile:<br> <input type="text" name="Mobile" size="30" maxlength="100"></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> <bR> <bR> <div> Or alternatively Fill in and send by post this form:</div> <bR> <bR> <div>   <a href="HTMLobj-231/desi-motherhelp.pdf"><u>service booking form</u> </a>  </div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 88 WIDTH="821"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="88" ALIGN="bottom" WIDTH="821" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></div> <bR> </td> </tr></table></body>