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Need a nanny or housekeeper referral?  Need a cook or house manager referral?  We can help you find nanny and/or domestic help or workers in Maryland, Virginia, DC, Baltimore and other locations throughout the U.S.!

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If you would like to apply to our company for assistance in helping you find a nanny, governess, domestic or home care worker referral then please complete the below Client Questionnaire and return it to us via e-mail or fax. For the quickest process to get you started right away in our company helping you locate in home help for your position, you may also call our office and we can take the information needed from you via telephone.


STEP 1. HIGHTLIGHT the TEXT in the below questionnaire to be copied.

STEP 2. Now you are ready to paste the text into your e-mail browser. You may also paste info into your word processor, (e.g., Word or Word Perfect application, etc.). Simply type in the answers needed for each question and return it to our office by emailing to:

STEP 3. If you choose to fax the below info then simply HIGHLIGHT the TEXT in the below questionnaire to be copied then print it out, complete and return it to our office by faxing to: 301-868-0484

That's It! You are finished!

Thank you for your application. We will be in touch with you shortly so be sure to check your e-mail regularly!

For now, we will withhold having you sign off on our registration agreement until we find you a suitable candidate to interview. Once we find such a candidate, we will then go over his/her employment info with you. It will be your decision to either accept or pass on interviewing a particular candidate. Prior to your interviewing any candidate or releasing his/her employment information, we will need to fax you our registration agreement. You will need to sign/date the document then return it to us by fax or mail. You do not have to pay us any upfront fees at this time. You only have to pay us the below service fees at the time you decide to hire a nanny/domestic referral through our company.

Service Fees:

$350/Part-time Nanny/Domestic Referral

$500/Full-time Nanny/Domestic Referral

Please complete and return the below Client Questionnaire to our office by e-mail or fax to: 301-868-0484 - E-mail us at:


List your Name (and husband'/partner's name if applicable):

Home/Phone #

Home/Fax #

E-mail Address

Address City State Zip

Motherís Occupation

(O) Tel. #

(O) Fax*

Fatheríís Occupation

(O) Tel. #

(O) Fax #

Does parents work from home?

List the days/hours you need help:

Have you hired in home help in the past?

What type of help is needed now?

Employment is for Full or Part-time, Live-in or Out, Long or Short-term or for the Summer months?

List the start date of employment:

List the weekly or hourly salary amount you plan to pay a job applicant: $
(Please stay within the job applicant salary rates suggested by our company - We ask that you do not list salary as "Negotiable" or leave as "blank" since it is too difficult for our company to attract a candidateís interest for interviewing and employing purposes if the salary is not listed.)

If applicable, list the name and age of your child/children along with the school days/hours:

1. Child's Name/Age
School hours/days
School Name/Location
2. Child's Name/Age
School hours/days
School Name/Location
3. Child's Name/Age
School hours/days
School Name/Location
4. Child's Name/Age
School hours/days
School Name/Location

Will the applicant be required to drive your child/ren in his/her own vehicle?

Will the applicant be required to drop off/pick up your child/ren from school?

Will the family be able to provide the applicant with a vehicle for job-related duties?

Do you have smokers in the home?

Do you have a pet in the home & who cares for them?

If applicable, list type of pet:

Do you have a swimming pool and if so, will the applicant be required to swim?

Are there other languages spoken in the home other than English?

If yes, list language:

Does your child/ren have a special need? If yes, list type of special need: For live-in help, will the applicant be required to travel with family?


List child care duties:

List comments here:

Briefly describe your family:

List home accomodations for live-in help (e.g., private bedroom, private level, private bath, t.v./radio use, computer/telephone use, vehicle use for job-related duties, etc.):

How did you hear about us?