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EMPLOYMENT APPLICATION
PERSONAL INFORMATION
List Job Applicant's Name: ELENA A.
List Home Address: Fort Washington, Maryland 20744
List Home Phone #: Withholding for now
GENERAL INFORMATION
Are you 18 years or older? Yes (56 years)
If employed, could you submit proof of your legal right to work in U.S. to your employer (Exp. a Resident Card, Work Permit or Student Visa)? Yes - Permanent Resident holder
Do you have at least two years of recent experience as a nanny, domestic worker or caring for the elderly? No on nanny and domestic help but "yes" to caring for an elderly gentleman (Elena's husband) - Elena only cared for her six grandchildren, ages 2 years through 12 years in the Philippines and ran her own household in housecleaning/cooking family meals
Do you speak English? Yes
Do you speak a fluent language other than English and if so, please list language(s)? Tagalog
Do you have a driver's license and do you have your own vehicle? No to both questions
If applicable, list the state you have your driver's license and the expiration date: N/A
List driving violations and dates if applicable: N/A
Do you wish to drive child/ren or adult in your vehicle while they are in your care? N/A
If yes, do you have adequate vehicle insurance? N/A
Do you prefer your employer provide you with a vehicle for job-related duties? N/A
Are you CPR certified for infants/children or adults and if so give us the certification exp. date? No - Non certified
Are you a smoker or a non smoker? Non smoker
If applicable, please let us know how many children you will care for and their ages? 1 or 2 children, ages, newborn up to teen years
Do you need to bring your child to work with you and if so, please list your child's age? No - Her children are grown adults
For elder care or companion care candidates, please briefly describe what you are looking for. N/A
DESIRED EMPLOYMENT
List the type (Nanny, nanny/housekeeper, housekeeper, day worker, elder care, companion care or other) of employment needed and let us know if you are available for full-time, part-time, live-in or out, short or long-term or a Summer position
Housekeeper, cook (Asian food is fine or American food but will need instruction), Housekeeper/Cook, Housekeeper/Nanny or Babysitter, Nanny/Housekeeper, Elder Care provider for an elder individual or couple (Non licensed), full-time, live-in and long-term employment
EMPLOYMENT AVAILABILITY/RELOCATION INFO
If hired, when can you start work? After Memorial Day - Tuesday, June 1, 2011 or very soon thereafter
List the days/hours you are available for work: Housekeeper: Prefer Monday through Friday but will consider Tuesday through Saturday - 8:00 to 5:00 p.m. or can be flexible with hours (40 -45 hours/week) - Child care: Flexible with days/hours at 40-50 hours/week being Monday through Friday or Tuesday through Saturday evening and off on two days/week (May need a 7-day live in with 2 days being off if job site is not w/in reasonable walk distance to public transportation) - Elder Care: For one adult will consider Monday through Friday, full-time, live-in 5 days/week (24 hours - 5 days/week), or maybe a 7-day live-in (24 hours - 7 days/week with 2 days off per month for herself
List locations you are willing to consider for work: Locations considered in Maryland are Bethesda, Chevy Chase, Gaithersburg, Germantown, Kensington, Brookville, Olney, Rockville, Silver Spring, Wheaton or most other areas as well, including Annapolis and Baltimore and surrounding areas, DC and most areas in the northern Virginia area.
Can you work overtime, if needed? Yes - will discuss at interview
Do you want to relocate for work in the U. S. and if so, list locations you will consider for employment? No
If applicable, are you willing to pay travel, lodging & food expenses as part of your relocating costs? No
DESIRED SALARY & EMPLOYEE BENEFITS
List salary expectations for weekly or hourly work schedule: She prefers to take home $500/week for housekeeping or nanny, nanny/housekeeper (1 child/light housekeeping, laundry, cooking w/recipe) duties - Elder care for one elder person is $500/week for a 5-day live-in (24 hours/5 days/week) and an additional $125 for each weekday worked - Tax issues and how deductions are to be made should be discussed with Elena during the interview.
List duties you will perform: Housekeeper - General housecleaning duties to include family laundry, cooking meals and perhaps light outdoor gardening work as needed - Nanny or Nanny/Housekeeper includes care/supervision of one child (any age), and if time allows will do light housekeeping, laundry and cooking meals (w/recipe)- Elder care includes care of one elder individual and all duties (non medically related) pertaining to this person.
List desired benefit's package: If offered, paid federal holidays, one or two week's paid annual vacation
If applicable, list live-in accommodations you will consider: N/A
EDUCATIONAL BACKGROUND INFORMATION
Did you graduate from high school in the U.S.? No
If you went to school in a country other than the U.S., indicate country: Philippines
Did you graduate from college: No
List the year you graduated: N/A
List the area of study and the type of degree you have: N/A
List the location of the educational institution? N/A
Are you currently a student? No
If so, please list your area of study, the days and hours of your classes: N/A
Please list a person's contact name and phone number in case of an emergency: Name/Phone #: Withholding for now
Have you ever been convicted of a felony? No
Note: Elena has only been in the U.S. since November 2010 - She has a valid SS# and Green Card. She will bring these documents with her at the time of being interviewed by the potential employer.
WORK REFERENCES
Applicant Name: ELENA A.
LIST WORK REFERENCES (List most recent employer first)
Elena does not have any child care or housekeeper work experience or references from former/current employers in the U.S. She had watched her six grandchildren, ages 1 year through 12 years and cleaned her own home while living in the Philippines. She also tended to her elder husband when he became critically ill in the Philippines. Her prior work history involved working in retail while she lived in the Philippines.
If you would like to meet with Elena A. in a job interview then contact our company to check to see if she is still available for employment. If she is available then we ask that you SIGN UP with our service by using our online Family Application. See below for this link. Thank you - We look forward to hearing from you!
CONTACT INFORMATION
FAMILIES HELP LINE
Office Telephone: 301-868-4420 (It is best to call between 9:00 a.m. and 5:00 p.m., EST, Monday through Friday.)
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