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Your Name:
Physical Address:
Postal Address:
Contact Numbers:	Home:    Fax: Work:   Cell: E-mail:
Names and Ages of children requiring a Governess:
Childrens' Schools:
Times required for Governess :
Start Date:
Duties:
Special Requirements:
Age Preference (if any) of Governess:
Other Comments:
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	Contact us at (011) 442-0722 or e-mail us at childcare@governess.co.za