Clients
Prospects
Testimonials
Contact Us
If you would like Park Cities Home Staffers to begin a search for your home staffing needs, we first need to get a few things out of the way. Please complete the form below then download, sign, and return our
placement agreement
.
First Name:
Last Name:
Address:
City:
State:
--Select State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Home Number:
Work Number:
Mobile Number:
Email:
Living Arrangements:
Live In
Live Out
Days of Employment:
(check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Hours of Employment:
Ages of Children:
Driving Required:
Yes
No
Car Provided:
Yes
No
Duties Expected:
Animals Present:
Yes
No
Pool at Location:
Yes
No
Employment Date:
(MM/DD/YYYY)
Salary Willing to Pay:
Vacation/Holidays Paid:
Yes
No
BY SUBMITTING THIS JOB DESCRIPTION, CLIENT UNDERSTANDS AND AGREES THAT AGENCY WILL NOT COMMENCE SEARCH UNTIL AGENCY RECEIVES A FULLY EXECUTED PLACEMENT AGREEMENT.
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