If you would like to apply to our company for assistance in helping you find a nanny, governess, domestic worker or elder care referral then please complete the below Client Questionnaire and return it to us via e-mail. To bypass completing and returning the below questionnaire back to our office you may contact us directly by telephone at 301-868-4420. Our office hours are Monday through Friday from 9:00 A.M to 4:30 P.M. (EST).
PLEASE FOLLOW THE BELOW INSTRUCTIONS WHEN COMPLETING/SENDING THE CLIENT QUESTIONNAIRE TO OUR OFFICE -- THANKS!
Simply copy the below questionnaire information by highlighting all of the text you want to copy then go to your email account
and open your email browser window as you do when you are ready to type and send a message to others or you may first try clicking on the below "Families Help Line" link and see if this brings up your email browser for you. Be ready to paste the below text into into your email browser window. From there you type in the answer needed for each question then return it to us by emailing to: FamiliesHelpLine@gmail.com
Families Help Line
That's it! You are finished!
Thank you for your application. We will be in touch with you shortly so be sure to check your e-mail regularly!
For now, we will withhold having you sign off on our service agreement until we find you a suitable candidate to interview. Once we find such a candidate we will then go over his or her employment information with you. It will be your decision as to either accept or pass on interviewing a particular candidate. Once you decide on meeting a particular candidate, we will need you to sign off on our service agreement. This document can be sent to you by fax and you may also fax it back to us. We will need this agreement signed/dated and returned to our office prior to your meeting the candidate in a job interview and prior to our releasing his or contact and employment application/work reference information to you. You do not have to pay us any upfront fees at this time to have us begin our candidate search on your behalf. You only have to pay us the below finder's upon your decision to hire a candidate through our company. In the event we are unable to provide you with a viable candidate for hire then you would not be liable for paying us any portion of the finder's fee shown below--a win/win situation!
Service Fees:
A Finder's Fee of $350 is due upon hire of either a part-time or full-time, live-in or live-out and long-term Nanny, Domestic Worker or Elder Care Referral
Please complete and return the below Client Questionnaire to our office by e-mailing it to: FamiliesHelpLine@gmail.com
CLIENT QUESTIONNAIRE
List your Name (and husband'/partner's name if applicable):
Home/Phone #
Home/Fax #
E-mail Address
Address City State Zip
Mother’s Occupation
(O) Tel. #
(O) Fax*
Father’’s Occupation
(O) Tel. #
(O) Fax #
Does parents work from home?
List the days/hours you need help:
Have you hired in home help in the past?
What type of help is needed now?
Employment is for Full or Part-time, Live-in or Out, Long or Short-term or for the Summer months?
List the start date of employment:
List the weekly or hourly salary amount you plan to pay a job applicant: $
(Please stay within the job applicant salary rates suggested by our company - We ask that you do not list salary as "Negotiable" or leave as "blank" since it is too difficult for our company to attract a candidate's interest for interviewing and employing purposes if the salary is not listed.)
If applicable, list the age of your child or children along with school days/hours:
1. Child's Age
School hours/days
School Name/Location
2. Child's Age
School hours/days
School Name/Location
3. Child's Age
School hours/days
School Name/Location
4. Child's Age
School hours/days
Will the applicant be required to drive your child/ren in his/her own vehicle?
Will the family be able to provide the applicant with a vehicle for job-related duties?
Do you have smokers in the home?
Do you have a pet in the home & if so who cares for them?
If applicable, list type of pet:
Do you have a swimming pool and if so, will the applicant be required to swim?
Are there other languages spoken in the home other than English?
If yes, list language(s):
Does your child/ren have a special need? If yes, list type of special need:
For live-in help only, will the applicant be required to travel with family?
JOB REQUIREMENTS
List child care duties:
List comments here:
List housekeeper duties:
List comments here:
List elder care duties:
List comments here:
Briefly describe your family:
If a nanny-share, briefly describe info about your family:
List your location:
List location(s) you will consider for nanny-sharing with a share family:
Whose home will be designated as the "host" home?
(A host home is where the nanny reports to work each day.)
We find nannies prefer to work with infants in a nanny-share where two families have only one infant per household. However, you may request a nanny for a nanny-share for a toddler or older child if you like and we will share your job details with available nannies. A maximum of two families, each having one child per household will only be considered in a nanny-share arrangement involving a nanny referral provided through our service.
List home accomodations for live-in help (e.g., private bedroom, private level, private bath, t.v./radio use, computer/telephone use, vehicle use for job-related duties, etc.):
How did you hear about us?
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