Application Form

IRISH AUNTS

Office Hours

MONDAY to FRIDAY

10a.m. - 12 noon

http://www.irishaunts.co.uk

Jack & Elizabeth Brownrigg

99 The Mount, Belfast BT5 4ND

office: (028) 9045 7900

fax: 028 9045 7919 ; mobile: 07050 057900

e-mail: info@irishaunts.co.uk

For Information Only

IRISH AUNTS was established in 1967 by Iris I. Brownrigg, based on her own career as a Princess Christian Children's nurse, and upon the need she found amongst families with whom she worked, for short term staff with the confidence and experience to run a household, and deal with virtually any eventuality.

Each "Irish Aunt" is assigned from a roll of carefully screened staff for short term (1, 2 or 3 week) assignments: always living in as a part of the family. The Agency occasionally takes on long term assignments with a small "team" of Aunts.

TERMS AND CONDITIONS (May 2011 to April 2012)

The signatory to the attached application form (hereinafter called the Applicant) shall make all payments of Fees to the Agency who shall make the appropriate disbursements of wages, Income Tax and National Insurance contributions on the Applicant's behalf.

REGISTRATION FEE £30.00 to be paid by the Applicant on returning the completed application form. Registration with the Agency is for life, covers all the Agency's services, and is not refundable.

AGENCY FEE £72.00 (minimum - for periods up to two weeks); £36.00 per week thereafter, to be paid by the Applicant to the Agency in advance of the Irish Aunt commencing work.

FEES FOR THE IRISH AUNT: The appropriate fee to be paid to the Agency in advance, inclusive of an allocation for the Employers National Insurance contribution, Employers Liability and Third Party Insurance and the payroll administration costs.

"A" rate - £87.90 per day (equivalent to £527.40 per six day week) for the care of an elderly or disabled where there is a degree of care and supervision required. (Historically the rate used for the care of children.)

"B" rate - £73.25 per day (equivalent to £439.50 per six day week) for house sitting, waiting at home for an assignment to start, payment in lieu of notice, or other special arrangement made with the applicant.

PART DAYS: When an Irish Aunt's departure time on the final day, significantly exceeds the arrival time on the first day, the fee for a full extra day will be due.

WORKING HOURS: An Irish Aunt's time is charged for SIX hours work per day at the A rate and FIVE hours work per day at the B rate. Apart from an essential daily 3 hour complete break from the household and charge(s), the Irish Aunt will remain on the premises "on call" in case of emergency UNPAID, living in as a member of the family, getting a full night's sleep. One full day off per week must be provided except where payment in lieu thereof is made through and by prior arrangement with the Agency.

CLEANING ALLOWANCE: In the event of the Applicant providing daily help for less than 6 hours per week, the Applicant shall pay the Agency by way of allowance for the Irish Aunt the sum of £14.65 per day.

RETURN TRAVEL EXPENSES: MILEAGE: HOUSEKEEPING MONEY: The Applicant shall pay the Irish Aunt's travel expenses for one return trip for each assignment. In the event of the Irish Aunt using a private car to travel to and from the assignment, the Applicant will pay the Irish Aunt's mileage at the rate of 25 pence per mile. In the event of the Irish Aunt's own car being driven in connection with the job, mileage will be paid at the rate of 50 pence per mile. Travel Expenses, Mileage and Housekeeping Money should be paid directly to the Irish Aunt by the Applicant, and should be accounted for by the Irish Aunt directly to the Applicant. If for any reason these moneys are administered through the Agency a handling fee of 11.75% will be charged.

ALTERATION OF ARRANGEMENTS:

POSTPONEMENT: If the expected starting date for an assignment is postponed or delayed by the Applicant, making it necessary for the Irish Aunt to wait at home without working, the Applicant shall pay for each such waiting day at the "B" rate of fees for the Irish Aunt.

CHANGE OF STAFF: In the event of the assigned Irish Aunt becoming ill or otherwise incapacitated, either before or during an assignment, the Agency shall make every reasonable effort to replace the Irish Aunt: in this event the Applicant may be liable for any additional travel expenses involved. In the event of the Applicant wishing, for reason of personality or any other, to change the Irish Aunt assigned, the Applicant should contact the Agency as soon as possible.

EXTENSION OF TIME BOOKED: In the event of the Applicant requiring the Irish Aunt for a longer period than that specified on the application form, the Applicant should consult the Agency at the earliest possible moment.

CANCELLATION: If the Applicant cancels the assignment, the Agency will retain the Agency Fee and if the Irish Aunt cannot be found suitable alternative employment, the Applicant shall pay the Agency the equivalent of not more than one week's Fee for the Irish Aunt in lieu of notice.

DRIVING: In the event of an Irish Aunt being requested by the Applicant to drive the Applicant's car, the Irish Aunt shall do so solely on the Applicant's policy of insurance and wholly at the Applicant's risk. In the event of the Irish Aunt's car being driven in these circumstances, it will be driven solely on the Irish Aunt's own policy of insurance and wholly at the Irish Aunt's risk. The Agency shall not be liable in any manner whatsoever for any damage caused to the Applicant's car or the Irish Aunt's car or the car of any third party or for personal injuries suffered by the Applicant, Irish Aunt or any third party howsoever arising.

SAFETY and INSURANCE: It shall be deemed to be the Applicant’s responsibility to ensure that the household is a safe place for the Irish Aunt to live and work, and, to compliment the Agency’s “Employers” and “Third Party” liability cover, that their “Household” insurance policy is valid and includes “Third Party” liability.

OUTSIDE THE UNITED KINGDOM: In the event of an Irish Aunt being required to work or travel outside the United Kingdom of Great Britain and Northern Ireland, the Agency will require satisfactory references from the Applicant.

The Fees and Allowances above are subject to alteration from time to time, and due notice of alterations will be given to the Applicant.

Overdue accounts may, at the Agency's discretion, be subject to a penalty charge of 1½% per month. Should the Applicant's cheque be returned by the bank due to errors, omissions, or any other reason, the Applicant shall be liable for any bank charges incurred.

The Agency will exercise reasonable care in the selection of Irish Aunts and other staff, but shall not be responsible for the acts or defaults of any person or the consequences thereof. The Irish Aunt (and not the Agency) shall be at all times the responsible party in charge of the Applicant's household.

APPLICATION FORM

To IRISH AUNTS (hereinafter called the "Agency") an Employment Business, Employment Agency and Nursing Agency operating under the Employment (Miscellaneous Provisions, N.I.) Order and licensed by the Department of Health and Social Services.

I hereby make application to be provided with a help (hereinafter called an "Irish Aunt") as specified below:

ASSIGNMENT ADDRESS:

INVOICE ADDRESS (if different):

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Post Code: . . . . . . . . Tel.No: . . . . . . . . . . . . . . . .

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Post Code: . . . . . . . . Tel.No: . . . . . . . . . . . . . . . .

NATURE OF HELP REQUIRED - please tick appropriate boxes (more than one may be selected)

q DOMESTIC MANAGER: to take over all aspects of running the household. (Light cooking and cleaning normally excludes heavy cleaning and function catering.)

q HOUSEKEEPER: to take charge of a household, under the supervision of the resident householder. (light cooking and housekeeping normally excludes heavy cleaning and function catering).

q ESCORT: to travel with and care for an elderly person in transit or on a shopping or other expedition.

q DRIVER: to drive the householder's or the Irish Aunt's own car for any purpose agreed with the Applicant, being for welfare of the assigned household and charge(s).

q SHOPPER: to do the household shopping as and when necessary, to pay for same by arrangement with the Applicant, and to account fully to the Applicant for all money spent.

q COMPANION

q MINDER: were supervision is required.

q CARER: strictly speaking, the Irish Aunt is only supposed to “run the household around” the charge(s) with the most limited amount of direct personal care.

q OTHER: please attach full details in writing to this application form.

PERSONAL AND HOUSEHOLD DETAILS

Number in Family: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …..

Details of any smokers in residence during Irish Aunt's stay: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …..

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Sex and age of charge(s): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …..

Details of any physical or medical condition which might affect the care of the charge(s): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …..

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Reasons why driver is needed: make/model of car available (if applicable): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . …..

Method of heating and cooking: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .....

Details of daily help, and other staff employed: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .….

Details of household pets if any (and who looks after them): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .....

EXACT DATES AND TIMES WHEN HELP WILL BE REQUIRED: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .….

Will the Irish Aunt be able to take one day off per week? (if so indicate when): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .....

I hereby declare that the information I have given above is correct, that the charge is in need of this care, and there are no other material circumstances of which you should be aware. I agree that this application and the terms and conditions, which I have also downloaded, form the Contract between the Agency and myself, and that this application and the said terms and conditions shall apply during any verbally agreed extension of the period of time mentioned above or further that in the event of the Agency supplying help before I have completed an application form the said conditions shall be deemed to apply from the date on which help is supplied.

Signed: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . . . . . . . . . . . . . . .....