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EMPLOYMENT APPLICATION
PERSONAL INFORMATION
List Job Applicant's Name: MATILDE F.
List Home Address: Silver Spring, Maryland 20906
List Home Phone #: Withholding for now
List E-mail Address: N/A
GENERAL INFORMATION
Are you 18 years or older? Yes (Mid 50s)
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 - A U.S. Citizen for a couple of years now
Do you have at least two years of recent experience as a nanny or domestic worker? Yes
Do you speak English? Yes
Do you speak a fluent language other than English and if so, please list language(s)? Portugese, some Spanish and French
Do you have a driver's license and do you have your own vehicle? Yes to both questions
If applicable, list the state you have your driver's license and the expiration date: Maryland
List driving violations and dates if applicable: None over the last 8 years
Do you wish to drive children or an adult in your vehicle while they are in your care? Yes, but will need additional pay on top of reg. weekly salary for gas mileage reimbursement expense? Yes - Will discuss prior to hire
If yes, do you have adequate vehicle insurance? Yes
Do you prefer your employer provide you with a vehicle for job-related duties? Yes
Are you CPR certified for infants/children or adults and if so give us the certification exp. date? CPR expired some years back
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?
Perhaps one or two teens who need only supervision, or on occasion child care for younger children with their priorities given over any household chores
Do you need to bring your child to work with you and if so, please list your child's age? No, both of her children are 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
First choice, Housekeeper and cook meals
Second choice, Housekeeper/Nanny supervising, driving one or two teens who need no care, occasionally child care for one or two younger children with their priorities being given over any household chores
Part-time, live-out and long-term employment
EMPLOYMENT AVAILABILITY/RELOCATION INFO
If hired, when can you start work? ASAP - Immediate employment is needed
List the days/hours you are available for work: Monday, Wednesday and Thursday during the hours of 9:00 a.m. up through 5:00 p.m. preferred but up until 6:00 p.m. if needed.
List locations you are willing to consider for work: Maryland areas including NW in DC, Bethesda, Chevy Chase DC, Chevy Chase Md, Potomac, Rockville, Silver Spring and surrounding area
Can you work overtime, if needed? Maybe on occasion
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? N/A
DESIRED SALARY & EMPLOYEE BENEFITS
List salary expectations for an hourly work schedule and duties you will perform:
Part-time Housekeeper or Housekeeper/Cook, Housekeeper/Nanny is $20/hour minimum at 20-hours/week - Up to $25/hour for a minimum of 15 hours/week - Duties include general housecleaning duties, cooking family meals, laundry, running errands to grocer, supervising/driving one or two teens, occasionally child care for one or two younger children where their priorities trump any household chores.
List desired benefit's package: 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: Portugal
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
Work REFERENCES
Applicant Name: MATILDE F.
LIST WORK REFERENCES (List most recent employer first)
(1) LIST THE NAME OF YOUR EMPLOYER: Wittie A.
LIST EMPLOYER'S PHONE NUMBER: Withholding for now
LIST JOB LOCATION (list city/state only): Potomac, MD
LIST DATES WORKED: 1990 - Current being 1 day/week
LIST YOUR JOB TITLE: Housekeeper, housekeeper/cook, laundress
LIST JOB DUTIES: Detailed housecleaning, laundry, ironing, cooking meals, running errands
LIST CHILDREN'S AGES: N/A
WHY DID YOU LEAVE THIS JOB? This job is current and Matilde will continue working with this family every Friday.
EMPLOYER'S COMMENTS: Talked to Wittie A. on 5-11-11 - She gave Matilde an
excellent work recommendation, commenting on her being an immaculate housekeeper and a good cook - Also, she commented on her being very trustworthy, reliable and a hard working individual and considered Matilde as a family member. If needed, anyone may feel free to contact this employer for additional information.
(2) LIST THE NAME OF YOUR EMPLOYER: Ms. K.
LIST EMPLOYER'S PHONE NUMBER: Withholding for now
LIST JOB LOCATION (list city/state only): Bethesda, MD
LIST DATES WORKED: 1997 - Current being 1 day/week
LIST YOUR JOB TITLE: Housekeeper
LIST JOB DUTIES: Housecleaning, laundry and ironing
LIST CHILDREN'S AGES: N/A
WHY DID YOU LEAVE THIS JOB? This job is current and Matilde will continue working with this employer.
EMPLOYER'S COMMENTS: Made contact with Judy K. on May 20, 2011 - Ms K. commented on Maltide being a lovely lady and a great housekeeper - Also, stated that you could eat off the floor after she cleans your home.
(3) LIST THE NAME OF YOUR EMPLOYER: Mr. W. A FOX News Commentator
LIST EMPLOYER'S PHONE NUMBER: Withholding for now
LIST JOB LOCATION (list city/state only): WASHINGTON, DC
LIST DATES WORKED: 2003 - 2006
LIST YOUR JOB TITLE: Laundress
LIST JOB DUTIES: Washed, folded and ironed clothing
LIST CHILDREN'S AGES: N/A
WHY DID YOU LEAVE THIS JOB? Matilde injured her shoulder due to too much stress on the joint from repetitive use of her arms, ironing clothing for too long of a period. She left this job on good terms with the Wallace family.
EMPLOYER'S COMMENTS: Talked to: Pending - Left message to return call.
If you would like to meet with Matilde F. 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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