Family Registration Information
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This agreement, made and entered into this day of by and between , whose address is and Palm Beach Nannies Etc...
Client is seeking the services of Palm Beach Nannies Etc...in assisting to locate a Nanny, Housekeeper, Doula, Newborn Specialist, Elderly Care, Personal Assistant for the client's personal use and client has made agreements with Palm Beach Nannies Etc... with regard thereto.
Client hereby acknowledges that they will pay a non refundable $250 service needed fees before interviewing process begins.
The service fees are as follows: - Temporary Placement: $1000.
- Permanent Placement: $2000.
- BabyNurse: $450
- Doula $500.
- Elderlycare $2800
- Personal Assistant $1000.
The retainer fee is built into the above fees, the balance is due when client has chosen their candidate. The client shall notify Palm Beach Nannies Etc... immediately before candidate begins work.
Any unpaid balance due to Palm Beach Nannies Etc..will be charged to the credit card the client has on file with PBN Etc.
Palm Beach Nannies Etc... agrees to replace a candidate within 3 months, at no additional charge to the client, should either party choose to terminate agreement ( client and or candidate).
There are no refunds, all services are final, and there will be a $25. charge for any returned checks.
Date (MM/DD/YYYY) Signature | |
| Family's Residential Information |
| Mom's First Name: |
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Dad's First Name: |
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| Mom's Last Name: |
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Dad's Last Name: |
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| Address Street 1: |
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City: |
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| Address Street 2: |
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Zip Code: |
(5 digits) State: |
| Mom's Phone Information |
Dad's Phone Information |
| Cell Phone: |
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Cell Phone: |
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| Work Phone: |
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Work Phone: |
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| Mom Email: |
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Dad Email: |
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| Children Information |
How many children
do you have: |
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What are their ages?: |
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| What activities do the children participate in?: |
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Are there any behavioral problems or handicaps?: |
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| Do you have any pets?: |
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Who cares for them?: |
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| What other languages does your family speak at home?: |
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Does anyone smoke?: |
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| Briefly describe the children's day, when their is no school. |
| Job Information |
| Type of Help Needed: |
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Placement Type Desired: |
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Schedule Needed:
From:
To: |
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
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| Will You Be Offering Benefits?: |
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Start Date?: |
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| Will traveling be involved?: |
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If yes, How often?: |
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Job Description
Please be as detailed as possible about job description |
| How Did You Here About Us: |
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