Domestic Information
   
Position:
Starting Date:
Salary:
Location:
 
Contact Information Information on the Residence
Name: 
Surname: 
Address: 
City: 
Country: 
 
Telephone: 
Mobile: 
Email: 
Permanent Position 
Temporary Position  
If temporary, 
for how long ? 
How many 
persons are living 
in the Household? 
How big is the 
household (size/staff)? 
What pets do 
you have? 
Do you have 
any children? 
yes  no
At what age 
are the children? 
       
Required Qualifications of Job Seeker
Green Card
American
yes  no
Driving License
yes  no
Other Visa
yes  no
Non-Smoker
yes  no
Indentify
   
Languages 
Spoken 
 
Required Qualifications & Licenses Job Descripion