Personal Assistant/Nanny Questionnaire - J Danielle

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(858) 225-8198 | staffing@jdanielle.com

| 6012 Paseo Delicias #3, Rancho Santa Fe CA 92067

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Personal Assistant/Nanny Questionnaire

1Personal Info

2General

3Talents/Specialties

4Additional Comments/Notes

Candidate name*
First Last
Phone*
Email*
How did you hear about us?

Resume sent in to J Danielle?
- Yes
- No
Letters of Recommendation & References sent in?
- Yes
- No
Photo for profile sent in?
- Yes I have
- No
Full time, Part time, Temp?
- Full time
- Part time
- Temp
Long term availability?
- Yes
- No
Available Days/Hours?
Where is your current location?
Location preference?
Live-in or Live-out?
- Live-in
- Live-out
- Either
Open to relocating?
- Yes
- No
Home office or corporate office environment preferred?
- Home office
- Corporate office
Pay rate approx. range desired?*

(Please indicate hourly or salary)
Okay with background check?
- Yes
- No
(National and International)
Middle initial & year born?
Clean DMV record?
- Yes
- No
(If not, it’s okay we just need a heads up.)
Please specify*
Able to work holidays?
- Yes
- No

Limit on number of children to care for?
Approx. ages of previously cared for children?
Trustline certified?
CPR certified?
- Yes
- No
Willing to obtain the two certifications above?
- Yes
- No
Have you been a Personal Assistant in the past?
- Yes
- No
Do you speak a second language?
Something neat about me is….
Please add ……

Okay with pets?
- Yes
- No
Okay with kids?
- Yes
- No
Cooking?
Allergies?
Please add applicable comments….

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Jamie Danielle Staffing

6012 Paseo Delicias #3
Rancho Santa Fe CA 92067
Email: staffing@jdanielle.com
Phone: 858.225.8198
Fax: 858.724.1442

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