Domestic Solutions
A professional domestic Placement agency
Please fill out all of the following information so we can
better serve you.
Name:
Street Address:
City, State, ZIP:
Phone Number:
Email:
How would you like to be contacted?
Type of help needed: (select as many as necessary)
Nanny
Nanny/Housekeeper
Couple
Housekeeper
Cook/Chef
Personal Assistant
Companion
Houseman
Other
Requirments:
Live In
Live Out
Part Time
Full Time
Is driving on the
job required?
Yes
No
If yes, do you
provide a car?
Yes
No
Approximate start date:
Briefly describe your needs:
