Employment Application - International Services Agency Beverly Hills

Applicant Registration

Please tell us about yourself: * denotes a required field.

First Name:

Middle Name:

Last Name:

Known by other name? List all:

Referred by:

Email:

Address:

City:

State:

Zip Code:

How long have you lived there?

Previous address:

Dates at previous address:

Home Phone:

Work Phone:

Cell Phone:

May we call you at work?

Marital Status:

Name of Significant Partner:

Alternate contact person:

Name:
Number:

Place of Birth:

Social Security Number:

Drivers License Number:

State Issued:

Is your Drivers License current?
Yes No

Date of Birth:

Any Arrests?
Yes No

Are you a U.S. citizen?
Yes No

Do you drive? Do you own a car?

Make of car:

Model of car:

Year of car:

Any accidents?
Yes No

Clean driving record?
Yes No

Are you in good health?
Yes No

Allergic to:
Cats
Dogs
Neither

I will work with:
Cats Dogs Neither

Do you smoke?
Yes No Occasionally

Do you drink alcohol?
Yes No Occasionally

Emergency name/address/phone:

Relation to you:

Driving on the job:

Can drive:
Limousine
Sports Car/Stick Shift
Luxury Car/Automatic

Have you ever been convicted of
"Driving Under the Influence?"

If yes, please explain:

Have you ever been arrested or convicted for theft, embezzlement, or any other criminal activities? (either misdemeanor or felony)

If yes, please explain:

Are you willing to work with a smoker?

Education:

Education: (Select all that apply)

High School
College
Trade School

Special Training/Classes
On The Job Training
Other

Skills: (List all)

Are you currently in school?

If yes, which institution?

Name of High School:

High school location:

Name of College/University

Majored in:

Degree achieved:

Medical skills and certifications:

Job Preferences:

Position applying for: (Select all that apply)

Estate Manager/Majordomo
Personal Assistant
Chef
Couple
Butler
Cook
Butler/Valet
Chauffeur/Driver
Security

Gardening/Landscaping
Airplane or Yacht Steward
Home Organizer
Governess
Nanny
Baby Nurse
Childcare
Estate Caretaker
House Keeper/Cook

House Keeper/Nanny
Housekeeping
Houseman/Handyman
Laundress
Companion/Elderly Care
Party Help
Licensed Nurse
Certified Nurses Aid

Male Attendant
Day Maid
Move In/Out Cleaning
Packing
Training - Current Staff
Training - Cooking
Consulting - All Aspects
Other:

Serving Style:

Room & Board:

Salary Range or Hourly Rate:

Full / Part Time:

Days off:

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Qualifications:

Years experience in private residence:

In what positions?

Experience in other fields: (Select all that apply)

Restaurant
Hotel
Private Airplane

Yacht
Other

Computer skills:
(List knowledge of)

Move In/Out Experience: (Select all that apply)

Packer
Day Maid
Organizer
Move In/Out Cleaning

Buying Supplies
Stocking Household
Working with Vendors

Flower Arrangements:

Consulting / Training: (Select all that apply)

Languages: (Select all that apply)

Training - Cooking
Training - Staff
Training - All household skills
Training - Some household skills
Training - Flower Arrangements
Training - Other

Consulting - All aspects
Consulting - Some aspects
Events/Party Planning - All
Events/Party Planning - Some
Consulting - Other

English
Spanish
French
German

Chinese
Japanese
Italian
Other

Type of Cooking: (Select all that apply)

Licenses or Certificates: (Select all that apply)

Gourmet
Continental
International
Healthy
Zone Cooking
Macrobiotic
Low Carb - Protien

Medically Restricted Diet
Plain
Plain American
Mexican
Asian
Other
None

Baby Nurse
Male Nurse/Attendant
Companion
Registered Nurse

License to carry (security)
Licensed Vocational Nurse
Certified Nurse's Aid
CPR
Other

Knowledge of Wine:

Are you willing to relocate?
Yes No

Are you willing to travel with the job?
Yes No

Are you willing to work in a home with children?
Yes No

What ages?

Will you do laundry and ironing?
Yes No

Will you wear a uniform?
Yes No

Have we placed you before?
Yes No

If so, where?

Are you employed now?
Yes No

When can you start work?

Employer 1: (1 of 4 References)

Employer:

Company name & address:

Business Phone:

Start date:

End date:

Salary:

Ages of children:

House/property size - sq.ft. / land size:

Your title:

Your duties:

Reason for leaving this job:

Employer 2: (2 of 4 References)

Employer:

Company name & address:

Business Phone:

Start date:

End date:

Salary:

Ages of children:

House/property size - sq.ft. / land size:

Your title:

Your duties:

Reason for leaving this job:

Employer 3: (3 of 4 References)

Employer:

Company name & address:

Business Phone:

Start date:

End date:

Salary:

Ages of children:

House/property size - sq.ft. / land size:

Your title:

Your duties:

Reason for leaving this job:

Employer 4: (4 of 4 References)

Employer:

Company name & address:

Business Phone:

Start date:

End date:

Salary:

Ages of children:

House/property size - sq.ft. / land size:

Your title:

Your duties:

Reason for leaving this job:

Anything else you want us to know to assist you?

My resume is:
Attached (see below)
I will email it
I will fax it

Attach resume: (if available)

My resume opens with:

Attach scan of driver's license/social security card: (if available)

The scan of my drivers license/social security card opens with:

Terms & Conditions: I understand I am submitting the above information voluntarily to be used for any background check that might be required
and I authorize DDON-International Services Agency and its agents or assigns to conduct such background check.

Free Consultation Available:

Send your resume and photo here

For a free consultation contact our office at 310.278.4470.

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