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Client Questionaire

Locke Domestic Agency
Matching quality and experienced candidates with quality homes

 

So we can best understand your professional household needs, please provide the following information below. You may submit it electronically, or print this form and mail or fax it to us.

First name:    MI   Last Name:
Address:
City: State/Province: Zip code:
Country:
Work phone: Home phone:
Fax:   E-mail address:

What type of staff members are you seeing? (Select all of the following that apply.)

Butler/Valet    Estate Manager    House Manager     Chauffeur

Gardener        Laundress           Chef/Cook          Housekeeper

Couple           Major-Domo        Houseman           Nanny

Personal Assistant                       Social Secretary

If none of the above are appropriate, please describe below:

Required Start Date:         Annual Salary Range:

Select any of the following options that apply:

Full-time        Part-time        Live-in       Live-out

Days and hours needed:

Monday:         
Tuesday:        
Wednesday:    
Thursday:       
Friday:           
Saturday:       
Sunday:           

Is some degree of flexibility required?

If so, please explain: