Staffing Inquiries for Employers

Contact Information

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Employer Name:
Email address:

Should another person be cc'd on correspondence? Yes No
If so, please provide e-mail address of that person:

Home Phone #: 


Work Phone #: 


Cell Phone #: 


Fax #: 

Home Address Where Candidate Will Work:
City:
State:	Zip Code:
Cross Street:  (if applicable)

Are there any special directions that are helpful to find the home?

Alternative Address (Mailing or Office):
City:
State:	Zip Code:

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Position(s) Available

What type of Position(s) would you like to fill?

Baby Sitter  Baby Nurse  Baby Guard  Butler  Chauffeur  Chef / Cook  Couple  Elder Care  Estate Manager  Executive Assistant  Executive Corporate Staffing  Executive Housekeeper

Event Staff  Home Health Aide  House Manager  House Sitter  Housekeeper  Houseman  Lady's Maid  Landscape Gardener  Launderer  Major Domo  Mother's Helper  Nanny / Governess

Other  Personal Assistant  Personal Security  Personal Trainer  Restaurant Chef  Senior Companion  Social Secretary  Vacation Home Staff  Valet  Yacht Staff  Yardman

If "Other", please describe position:

Is this a confidential search?  Yes   No

Type of Position:
 Live In    Live Out

 Part Time (under 35 hours per week)    Full Time (35+ hours per week)

 Long Term (one year or longer)    Temporary (less than one year)

Start Date:

End Date (if applicable):

Is there any other domestic help employed in the house?  Yes    No
If yes, please list titles, responsibilities, and schedule:

Is there anyone currently employed in the desired position?
 Yes    No
If yes, please describe the situation:

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Schedule

Days and Hours Needed:
Monday    Tuesday

Wednesday    Thursday

Friday    Saturday

Sunday

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Responsibilities

What duties will employee be expected to perform? (check all that apply)

Childcare  Driving Children  Cooking for Children  Purchasing Children's Items  Child Related Event Planning  Children's Laundry  Attending Classes with Children  Overnight Care

Managing Family Calendar  Homework Help  Cooking for Family  Meal Preparation  Complete Housekeeping  Light Housekeeping  Personal Shopping  Grocery Shopping

Pet Care  Family Laundry  Scheduling Service Personnel  Errand Running  Travel with the Family  Household Event Planning  Computer Work  Other

If there are "other" responsibilities, please provide details:

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Household Environment

Please describe your residence (i.e. formal, casual, house, apartment, square feet)


Do you have a pool? Yes   No

Do you have pets? Yes   No
If you have pets, please specify

Will pet care be required? Yes   No

Will the employee be required to travel? Yes   No
If so, how often:
Do you have allergies? Yes   No
If you have allergies, please specify

Do you require a candidate to drive? Yes   No
Can you provide a car? Yes   No

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Live-In (if applicable)

Detached Cottage
Room in House with Private Bath
Room and Bath with Separate Entrance
Room in House with Shared Bath

Please describe living quarters:

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Compensation and Benefits

Desired Budgeted Annual Salary Range, Based on Duties and Experience of Candidate:
From:   To:

Or Weekly Range, Based on Duties and Experience of Candidate:
From:   To:

Or Hourly Range, Based on Duties and Experience of Candidate:
From:   To:

Will Medical Insurance be provided? Yes   No

Are any there any other additional benefits that will be offered to the candidate?

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Search Information

How did you hear about Hampton Domestics?
I am a previous client   Friend   Magazine   Newspaper   Internet   Other

Meeting With Us In Person Can Help Us to Understand the Requirements of Your Position. Are You Interested in Scheduling an In-Residence or In-Office Visit With a Hamptons Domestic Agency Specialist? Yes   No

What Days and Times Are Best to Schedule Interviews for You With Potential Candidates?

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