Housekeeping Client Application

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Client Information

Client's name:*

Client's first name Client's last name

Occupation:

Employer:

Address:*

Street Address City State / Province / Region ZIP / Postal Code Country

Are there any special directions to find the home?

(e.g. hidden drive, landmarks, security gate)

Phone number type:*

Phone:*

Email:*

Enter Email Confirm Email

Partner's name:

Partner's first name Partner's last name

Occupation:

Employer:

Phone:

Email:

Search lead name:

(e.g. who will be leading the search for this role if different than client)

Phone:

Email:

Who will make the hiring decision?*

Is this role associated with an organization (e.g. business, LLC, trust, conservatorship)*

Yes

If yes, please provide the organization's name:

Who should be copied on search correspondence?*

If there are children in the home, please list each child's name, sex, and Date of birth, allergies, and any schedule considerations:

Name

Gender

Date of birth

Allergies

Schedule considerations

Are there other adults in the home?*

Yes

If yes, please list their names and ages:

Name

Age

Are there pets in the home?*

Yes

If yes, please provide the following information:

Name

Breed

Age

Weight

How did you hear about us?*

Candidate referral

Client referral

Community marketing outreach

Corporate employer program

Email marketing

Event planner

Friend

Google

Hotel partner

Marketing advertisement

Moms group

Returning candidate

Returning client

School partner

Social media (IG, FB)

T+C website

Trusted business partner

Other

If referred, please indicate by whom so we can thank them:

Job Description

Is this a confidential search?*

Yes

Type of household professional*

Executive Housekeeper

Housekeeper

Laundress

Light Housekeeper

(please specify at least one):

Type of position you are seeking:*

Full-time

Part-time

Live-in

Live-out

Long-term

Temporary

Start date:

MM slash DD slash YYYY

End date

MM slash DD slash YYYY

(if applicable)

Days and hours needed:*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Which time frame would you like coverage for each day of the week?*

Same time each day

Different times each day

If so, please specify the time.

If you prefer different coverage time frames for each day, please specify the times for each day below.

Comments:

Please indicate any additional details about your preferred start or end date.

Will overtime and weekends be required?*

Yes

If yes, how often?

Will the candidate for this position be required to work holidays?*

Yes

If yes, please specify?

Is there any other information we should know about the required schedule?

Is a uniform required or do you have a preferred dress code?*

Yes

If yes, please describe:

Is there anyone currently employed in this position?*

Yes

If yes, please describe the situation:

Core Responsibilities

Laundry*

Adult's laundry

All personal clothing

Children's laundry

Fine fabrics

Handwashing of linens

Household linens

Ironing*

Touch-ups

Steaming

Describe your cleaning expectations*

(preferred cleaning supplies, fine furnishiings, etc.):

Secondary Responsibilities

In addition to their specific job responsibilities, please check secondary job duties:*

(check all that apply)

Driving children

Errands

Grocery shopping

Household organization

Liaise with vendors

Maintain wardrobe

Meal prep (washing, chopping)

Oversee dry cleaning

Polishing silver

Supervising children

Vehicle maintenance

Washing dishes

Will pet care be required?*

Yes

If yes, please check all that apply:

Clean-up after

Feed

Take to veterinary appointments

Walk

Will occasional childcare be required?*

Yes

If yes, please describe the situation: Frequency, for whom:

Is there any other information we should know about the duties to be performed?

Please describe your ideal candidate: (e.g. level of experience, education, personality)*

Household Environment

Is this position for your primary residence?*

Yes

If no, please explain:

Please describe your home:*

(e.g. size, formal, casual, house, apt):

What is the approximate square footage of your home:

What is the number of levels in your home:

What is the number of bedrooms:

What is the number of bathrooms:

Do you employ other domestic help?*

Yes

If yes, please list titles, responsibilities, and schedule:

Do either you or your partner work from a home office?*

Yes

If yes, how often?

Is there a household manual for your staff?

Yes

Will parking be provided?*

Yes

If yes, please describe:

Is there any special information the employee should know about parking near your house?

Will the employee be required to drive?*

Yes

If driving is required, will the employee need their own car for the job?

Candidate must have their own car

We can provide a car, if needed

We will provide a car, and the employee should use that car for the job

If this is a live-in position, please describe quarters:

Detached cottage

Room in a house with private bath

Room and bath with separate entrance

Room in house with shared bath

Additional information about living quarters:

Describe a typical day for the employee*

Compensation and Benefits

Salary range: (based on duties and experience of the candidate)

Exempt (salaried positions) or non-exempt (hourly):*

Exempt

Non-exempt

From $*

To $*

Benefits to be provided:

Paid sick days (# of days)

Paid holidays (# of paid holidays)

Paid vacation (# of vacation days)

(check all that apply)

Please indicate amount:

Your placement counselor will provide additional guidance about competitive benefits.

Medical insurance:*

Yes

Medical insurance - If yes

Health care benefit

Stipened

$ amount

Please indicate amount:

Retirement plan*

Yes

Commuter reimbursement*

Yes

Other

Would you like a referral for a payroll provider?*

Yes

Communication Preferences

What is the best way to communicate with you about your search:*

Texting

Phone

How would you like your candidate to communicate with you?*

Texting

Phone

(select all that apply)

Our Contract with You

The terms and conditions under which Town + Country Resources, Inc. will provide its services to you are shown below. By ticking "I have read and agree to the above terms and conditions" and clicking "Agree and send," this will become our written contract signed by you. You will receive an email copy of this contract at the email you provided above.

Authorization*

I am authorized to execute this agreement on behalf of the company named above

Referral Agreement*

I have read and agree to the above Town + Country terms and conditions, Privacy Policy and Terms of Use

Name

This field is for validation purposes and should be left unchanged.

Housekeeping Client Application

Client Information

Job Description

Core Responsibilities

Secondary Responsibilities

Household Environment

Compensation and Benefits

Communication Preferences

Our Contract with You

Enhance your home and enrich your life with Town + Country Resources

Contact Info

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