Reception - (bar/anapest)

<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 Pair</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> <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>  <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html> <head> <base href="http://fs11.formsite.com/emil_b_g/" /> <meta http-equiv="Content-Type" content="text/html;CHARSET=iso-8859-1" /> <title>Booking Mother Help</title> <link rel="stylesheet" type="text/css" media="all" href="/include/form/screen4.css" /> <link rel="stylesheet" type="text/css" media="print" href="/include/form/print4.css" /> <style type="text/css" media="all"> body{ background: #FFFFFF; } a{ color: #0000FF; } a:visited{ color: #0000FF; } .form_table{ width: 605px; overflow: hidden; margin-left: auto; 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action="http://fs11.formsite.com/fs11_app/FormSite" method="post" enctype="application/x-www-form-urlencoded" id="FSForm" onsubmit="processSubmit(this);"> <div style="display:none;"> <input type="hidden" name="FormId" size="-1" value="FormResult" /> <input type="hidden" name="UserNbr" size="-1" value="1128019" /> <input type="hidden" name="FormNbr" size="-1" value="1" /> <input type="text" name="subject_line" /> <input type="hidden" name="FormKey" size="-1" value="954031672" /> <input type="hidden" name="ElapsedTime" id="ElapsedTime" size="-1" value="0" /> <input type="hidden" name="Referrer" id="Referrer" size="-1" value="" /> </div> <script type="text/javascript" src="/include/form/form.js"></script>  <div class="form_table"> <br class="clear"/> <div id="q0" class="q full_width"> <a class="item_anchor" name="ItemAnchor0"></a> <div class="segment_header" style="color:#000000;background-color:#FFFFFF;width:100%;text-align:Center;"><h1 style="font-size:18px;">Nanny and Mother's help booking form</h1></div> </div> <br class="clear"/> <div id="q1" class="q required"> <a class="item_anchor" name="ItemAnchor1"></a> <label class="question top_question" for="RESULT_TextField-1"><b>*</b> First Name</label> <input type="text" name="RESULT_TextField-1" class="text_field" id="RESULT_TextField-1" size="22" /> </div> <div id="q2" class="q required"> <a class="item_anchor" name="ItemAnchor2"></a> <label class="question top_question" for="RESULT_TextField-2"><b>*</b> Last Name</label> <input type="text" name="RESULT_TextField-2" class="text_field" id="RESULT_TextField-2" size="22" /> </div> <br class="clear"/> <div id="q3" class="q"> <a class="item_anchor" name="ItemAnchor3"></a> <label class="question top_question" for="RESULT_TextField-3">Address</label> <input type="text" name="RESULT_TextField-3" class="text_field" id="RESULT_TextField-3" size="52" /> </div> <br class="clear"/> <div id="q4" class="q required"> <a class="item_anchor" name="ItemAnchor4"></a> <label 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<input type="text" name="RESULT_TextField-7" class="text_field" id="RESULT_TextField-7" size="25" /> </div> <br class="clear"/> <div id="q8" class="q required"> <a class="item_anchor" name="ItemAnchor8"></a> <label class="question top_question"><b>*</b> Service required</label> <table class="inline_grid"> <tr> <td><input type="radio" name="RESULT_RadioButton-8" class="multiple_choice" id="RESULT_RadioButton-8_0" value="Radio-0" /><label for="RESULT_RadioButton-8_0" >Mothers Help</label></td> </tr> <tr> <td><input type="radio" name="RESULT_RadioButton-8" class="multiple_choice" id="RESULT_RadioButton-8_1" value="Radio-1" /><label for="RESULT_RadioButton-8_1" >Part - time Nanny</label></td> </tr> <tr> <td><input type="radio" name="RESULT_RadioButton-8" class="multiple_choice" id="RESULT_RadioButton-8_2" value="Radio-2" /><label for="RESULT_RadioButton-8_2" >Full - time Nanny</label></td> </tr> <tr> <td><input type="radio" name="RESULT_RadioButton-8" class="multiple_choice" id="RESULT_RadioButton-8_3" value="Radio-3" /><label for="RESULT_RadioButton-8_3" >Housekeeper</label></td> </tr> <tr> <td><input type="radio" name="RESULT_RadioButton-8" class="multiple_choice" id="RESULT_RadioButton-8_4" value="Radio-4" /><label for="RESULT_RadioButton-8_4" >Homework Supervision</label></td> </tr> <tr> <td><input type="radio" name="RESULT_RadioButton-8" class="multiple_choice" id="RESULT_RadioButton-8_5" value="Radio-5" /><label for="RESULT_RadioButton-8_5" >Au Pair</label></td> </tr> </table> </div> <br class="clear"/> <div id="q9" class="q required"> <a class="item_anchor" name="ItemAnchor9"></a> <label class="question top_question" for="RESULT_TextField-9"><b>*</b> Date from when you are looking for nanny</label> <input type="text" name="RESULT_TextField-9" class="text_field" id="RESULT_TextField-9" size="25" /> </div> <br class="clear"/> <div id="q10" class="q"> <a class="item_anchor" name="ItemAnchor10"></a> <label class="question top_question" 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