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Form for employers looking for a nanny or caregiver.
First Name:
Last Name:
Address:
City:
Postal Code:
Home Phone:
Work Phone:
Cell Phone:
Email:
Age Preference of the caregiver:
Are you looking for a fulltime or part time staff? Full-Time Part-Time
Are you looking for a live-in or live-out staff? Live-In Live-Out
Duties and Responsibilites?
Number of adults in your household:
Number of children in your household:
Ages of your children:
Do you have pets? Yes No
Smoking household? Yes No
Are you willing to sponsor from local and overseas? Yes No
Do you require care for children with special needs? Yes No
Do you prefer a male or a female caregiver? male female
Do you currently employ any other household staff and if so what is their title and job:
Accomodation (for live in staff only give a brief description of the room they will be staying in):
Which days of the week will you will require him/her/them to work:
Hours of work per day: Salary (your offer)?
Other Benefits:
Other information concerning the position:
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