Live In Client Application Form
First Name: *
Last Name: *
Street Address:
Zip: *
City in Miami-Dade County: *
i.e., Coral Gables or Pinecrest or Aventura
E-mail: *
Cell Phone: *
Home Phone:
Job Description: *
Select all that apply
Required
What position are you looking to fill? *
Select all that apply
Required
List Days of Work Schedule *
i.e., Monday - Friday
List Hours of Work Schedule *
i.e., 9am-5pm
Child(ren) or Elderly Person:
please provide name, age, and gender
What household duties do you wish the employee to perform?
Check all that apply - be mindful of your needs.
What requirements do you require the employee to possess?
Check all that apply - be mindful of your needs.
If dietary laws, which kind?
If pets, what kind?
If pets, please list the employee’s responsibilities with the animal(s)?
If yes, what are your typical travel destinations?
What other qualifications do you require?
Please list any disqualifying factors?
Family/Job Dynamics:
Check all that apply.
Which holidays would the employee have off?
What is the salary range PER WEEK for live in? *
General preference of interview days and times: *
Turn by turn directions to your house/interview location: *
If applicable, please include parking instructions (i.e., valet at building)
Location of public transportation:
How did you learn about Class Act Nannies, LLC?
When do you need the candidate to begin employment? *
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