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Employing a Home Helper
Please fill out the information in the form below.
First Name:
Middle Name:
Last Name:
Address:
City:
Province:
Select
AB
BC
MB
NB
NF
NT
NU
NS
ON
PE
QC
SK
YT
Postal Code:
Home Phone:
Work Phone:
Note: you must enter a valid email address to change your information later?
Cell Phone:
Email Address:
Contact name (if different):
Main Intersection:
Are you looking for full time or part time staff?
Full Time
Part Time
Are you looking for live-in or live-out staff?
Live In
Live Out
Duties and Responsibilities
Adults in your household:
Children in your household:
Ages:
Do you have pets?
Yes
No
Smoking Household:
Yes
No
Do you currently employ any other household staff and if so what is their title and job:
Accomodation (for live in staff only give a brief description of the room they will be staying in):
Which days of the week will you will require him/her/them to work:
Hours of work per day:
Salary:
Other benefits:
Other information concerning the position:
?Home Helpers 2005.
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