The Larchmont Employment Agency

Childcare/Domestic Placement Services

Tel. (914) 834-1611
FAX (914) 834-3663

Home  |  About Us  |  Families  |  Candidates  |  Contact Us

Home  |  About Us  |  For Families  |  For Candidates  |  Contact Us

Larchmont Employment Agency, Inc.
Copyright 1998

Tel     914.834.1611
FAX  914.834.3663

Larchmont Employment
Agency, Inc.

Childcare/Domestic Placement Services

We would appreciate it if you would take a few moments to answer the following questions. Please be assured that we do not share or sell personal information about you.

Address:
City
State
Zip Code
(Mr) E-mail Address:
Home Telephone
(Mr) Office Telephone:
Home / Office FAX
Bold = Required field
Family Last Name
(Mr) First Name
(Mrs) First Name
(Mr) Cell phone:
Nanny
Mother's Helper
Baby Sitter
Newborn Specialist
Housekeeper
Household Manager
Other (specify)
Live In
Live Out
Either
Full Time
Part time
Permanent
Temporary
Is Driving Necessary?
Yes
No
What type Vehicle Will Be Provided?
Number of Children (male/female)
Ages
Do You Have Pets?
Yes
No
Type?
Brief Description of responsibilities (i.e. schedule/days;average hours;days off; etc.)
Children's laundry only
Family Laundry
Cooking for children only
Family Cooking
Tidy up after children
Light Housekeeping
Full Housekeeping
Grocery Shopping
Pet care
Errands
Start Date
Convenient Time to Interview Candidate? (weekend, evening, other)
Salary Offered:
List Benefits Offered? (medical insurance;vacation;personal days;travel;education;other)
Candidate's smoking status:
Smoker
Nonsmoker
Does Any Family Member Smoke?
Yes
No
Brief Family Description: (what we should know, i.e.formal, informal etc.)
Name:
Years Known:
Telephone Number:
Previous Employee
Family Friend
Other
Verizon Yellow/Super pages
Yellow Book
AOL
Westchester/CT Family Magazine
Google
Yahoo
Friend
Other
I agree that all family information supplied is true and accurate:
Occupation:
Occupation:
Post Card/Mail
(Mrs) Cell phone:
(Mrs) E-mail Address
(Mrs) Office Telephone
What type of employee(s) are you seeking?
Living Arrangements:
The position you are offering is:
(If "yes" is checked, Vehicle Must be Provided)
Candidate is required to: (please check appropriate boxes)
A family reference is requested because we care about our candidates and the homes in which they are placed.  This could be a previous employee, close family friend, or other:
How did you hear about Larchmont Employment Agency?
Once your application is received, we will contact you to discuss potential candidates.

Fill Out the Larchmont Employment Agency Family Application

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