Personal / Executive Assistant Questionnaire 1Personal Info2General Preferences3Duties Include4Additional Requests/Notes Family name* Email* Phone*How did you hear about us? Estimated start date Location Address of position Full time, Part time, Temp? Full time Part time Temp Desired Days/HoursMale or female preference Male Female Pay rate approx. range* (Please indicate hourly or salary)Health benefits/401K applicable? Yes No Live-in or Live-out? Live-in Live-out Either If Live-in, separate living quarters?* Yes No Relocation costs covered? Yes No Household is Casual, Semi-formal or Formal? Casual Semi-formal Formal General home management Yes No Home office work Yes No Cooking Yes No Laundry / ironing Yes No Shopping Yes No Driving / errands? Yes No Help with family/kids/pets? Yes No Table service/parties Yes No Cook in or serve food already prepared Cook In Serve Food Both Please add…. Special diet requirementsAllergies to be aware of It would be really nice if….Misc.Advanced Background Check from 3rd party + $60 Yes No Δ ShareTweetShare0 Shares