Client Application | DomesticMatch.com

Have questions? • San Francisco 1-415-866-0800 • Peninsula 1-650-798-7988 • info@domesticmatch.com
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Begin your search for a Pre-Screened candidate here. We will contact you by the end of the next business day. If you need immediate assistance please contact us at info@domesticmatch.com.

Your Contact Information
First name*	Last name*
Email address*
Office phone	Office fax
Cell phone*

Partner's name	Email address
Office phone	Office fax
Cell phone
Should partner be cc'd on emails? Yes No

Home address	Apartment #
City	State	ZIP code
Are there any special directions to find your home? (Security gate, hidden drive, etc.)
Home phone	Home fax
Email
Contact Person
Contact phone	Contact fax
Contact email

Search Information
How long have you been looking for an employee?
Are you using other agencies for this search?* Yes No
If yes please describe
Is this a confidential search? Yes No
How did you hear about DomesticMatch?*
If Other
What days and times are best for you to interview potential candidates?
Have you seen a candidate on DomesticMatch.com that you are interested in? Yes No
If yes please enter candidate ID number

Search Information

How long have you been looking for an employee?

Are you using other agencies for this search?* Yes No

If yes please describe

Is this a confidential search? Yes No

How did you hear about DomesticMatch?*

If Other

What days and times are best for you to interview potential candidates?

Have you seen a candidate on DomesticMatch.com that you are interested in? Yes No

If yes please enter candidate ID number

Home Details
How many square feet?
How many levels?
How many bedrooms?
How many bathrooms?
Style of your home (formal/semi-formal/casual)
Do you own other homes? Yes No
If yes please describe
Are your other homes staffed? Yes No
If yes please describe

Home Details

How many square feet?

How many levels?

How many bedrooms?

How many bathrooms?

Style of your home (formal/semi-formal/casual)

Do you own other homes? Yes No

If yes please describe

Are your other homes staffed? Yes No

If yes please describe

Candidate Information
Calm Yes No
Efficient Yes No
Discreet Yes No
Easy going Yes No
Cheerful Yes No
Warm Yes No
Chatty Yes No
Reserved Yes No
Flexible Yes No
Self-starter Yes No
Takes direction Yes No
Organized Yes No
Formal Yes No
Other traits
Private home experience preferred?
Do you require the candidate to wear a uniform? Yes No
If yes please describe
Do you require the candidate to speak another language? Yes No
If yes please describe
Please describe your ideal candidate

Salary Information

Salary range $ per

Payment frequency

Daily	Weekly
Every 2 Weeks	Monthly
Other

Meals
The employee will eat what the household provides? Yes No
If yes please describe
The employee will bring their own meals to work? Yes No
If yes please describe

Meals

The employee will eat what the household provides? Yes No

If yes please describe

The employee will bring their own meals to work? Yes No

If yes please describe

Car Policy
Is there a vehicle available for employee use? Yes No
If yes please describe
Is vehicle available for personal use? Yes No
If yes please describe
Is the employee required to use their own vehicle for work? Yes No
If yes please describe
Will you reimburse the employee for use of their personal vehicle? Yes No
If yes please describe

Car Policy

Is there a vehicle available for employee use? Yes No

If yes please describe

Is vehicle available for personal use? Yes No

If yes please describe

Is the employee required to use their own vehicle for work? Yes No

If yes please describe

Will you reimburse the employee for use of their personal vehicle? Yes No

If yes please describe

Live In Employee Accommodation
Separate from the main house Yes No
In main house Yes No
Separate entrance Yes No
Furnished Yes No
Private bathroom Yes No
Storage space Yes No
TV Yes No
Cable Yes No
Phone Yes No
WIFI access Yes No
Parking Yes No
Other Yes No
Is the accommodation included as part of the compensation? Yes No

Miscellaneous
Please describe your house rules
What is a typical day like in your home?
Uniform required

Childcare Information
Driving children Yes No
Prepare meals for children Yes No
Prepare meals for adults Yes No
Clean children's rooms Yes No
Clean children's bathrooms Yes No
Clean kitchen area Yes No
Make children's beds Yes No
Wash children's laundry Yes No
Iron children's clothes Yes No
Wash adult's laundry Yes No
Iron adult's clothes Yes No
Organize play area Yes No
Daily walks with child Yes No
Take child to museums /cultural centers Yes No
Read with children Yes No
Take children swimming Yes No
Teach another language Yes No
Light housekeeping Yes No
Complete housekeeping Yes No
Grocery shopping Yes No
Personal shopping Yes No
Homework assistance Yes No
Tutor children Yes No
Plan birthday parties/other events Yes No
Overnight care Yes No
Pet Care Yes No
Travel with the family Yes No
Please tell us about other skills that you would like your childcare provider to have
Please describe your children's personality, preferences, habits
Do your children have any special needs (physical/emotional/medical) Yes No
If yes please describe
Do you have a pool? Yes No
Will the candidate be required to swim? Yes No
Please describe your expectations of your childcare provider

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Contact Us

If you have a question or need help beginning your search, please contact us and we will be happy to answer any questions you may have.

DomesticMatch
1259 El Camino Real
Suite 233
Menlo Park, CA 94025
Tel 650.798.7988
eFax 650.899.1877
Email info@DomesticMatch.com

Client Payments

If you are a client wishing to make a payment, please use the link below to make your payment by credit card or your PayPal account.

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