Name 1: BUS# FAX#
Name 2: BUS# FAX#
Home Address: H. Tel# FAX#
 
City 		Province
Postal Code
Your E-mail Address:
Closest Main Intersection:
Occupation: Mother: Hours
Father:  Hours
Children:
Name             Date of Birth        Age             School
1)
2)
3)
4)

Other adults in home Cleaning Help Pets

Start date preferred: latest by:
Do you prefer a non smoker?: Do either parent work from home?:
Will you accept a social smoker?:
Age range preferred: Other Preference:
Child care training: Experience:
Swimmer? Yes No Do you have a swimming pool? Yes No
Driver's licence ? Yes No Car available? Daytime? Yes N
Time off? Yes No
Own car required? Yes No Required to drive children? Mileage paid?
Work Schedule:
 
Wages offered: Overtime anticipated:
Benefits: Paid sick days?
Accommodation:

Duties required of the employer:

Newborn - 1 yr. 1 yr. to 3 yrs. 3 yrs. to 5 yrs. 5 yrs. to 8 yrs.
8 yrs. to 12 yrs. Teenagers Change Diapers Toilet Train
Prepare Breakfast Prepare Lunch Prepare Snacks Prepare Dinner
Children's Laundry Children's Beds Clean Bedrooms Children's Bathroom
Drive to School Walk to School Take to Activities Assist With Homework
Any Special Childcare Needs

General Housekeeping:

VACUUMING: Child Related Areas only Throughout, minus Master Bdrm. Throughout
DUSTING: Child Related Areas only Throughout, minus Master Bdrm. Throughout
SPONGE MOPPING FLOORS: Kitchen Main Bathroom Halls Other
EVENING MEAL: Prepare Assist Meal Planning by Parents Clean Up
BREAKFAST: Family Children Only  
LUNCH Family Children Only  
LAUNDRY Family Children's Ironing
  Full Responsibility Assist  
  Bed Linen: Household Bed Linen: Children's  
  Bath Towels : Household Bath Towels : Children's  
PET CARE: Dog(s) Cat(s) Other
  Feed Walk Other
Household Appliances :
Oven / Stove Microwave Dishwasher Trash Compactor
Washing Machine Dryer Vacuum Cleaner Wall Vacuum
Are you a previous client? If so, when?
Whom shall we thank for referring our services?

SERVICES AND FEES :

INITIAL SEARCH FEE (ISF) to register and begin a search :      $100.00 plus GST

Exception : No ISF payable in advance for Part Time Positions of less than 18 hours per week. If we are able to find suitable candidates for interview, the ISF will be payable upon placement OR prior of arrangement of an interview for a third possible candidate, whichever comes first.


PLACEMENT FEES :

  • LIVE-IN on LCP Work VISA Full Service Contract $1200.00 + GST(Local & Overseas)
  • Local LIVE-IN or OUT Full Service Contract ( Cdn., Landed citizenp) 3 weeks Gross Wages ( to a max. $1800.00) + GST (all Canadians / Landed Immigrants / those on Open Work Permit )

WE OFFER A 9 MONTH GUARANTEE on our Full Service Contract.

Should you wish to register with Trafalgar Personnel and have us begin a search on your behalf, please check this box indicating how you will forward your Initial Search Fee.

Forwarding by mail today.
Will drop off a cheque / payment at the office within the next 4 days.

Please check here to indicate that all the information you submitted is correct and that you have read, and agree with the Agency Fee schedule.

Name of Sender : Date : e-Mail : .

Trafalgar Personnel Ltd. will not to disclose your private information to any third party other than potential caregivers, except if required to do so by law, or in the good faith belief that such action is necessary to comply with legal process, respond to claims, or to protect the rights, property of TP. 

We take all reasonable care, both technically and in practice, while handling your personal information to ensure its security both offline and online.