Client Registration

Palm Beach Domestics is a first class domestic placement firm, with in-house service experience of over 10 years. We conduct a 7 point screening of all of our prospective placements. We also provide referrals for CPR/ First Aid certification to all placements whose employer requests it.

Palm Beach Domestics requires a non-refundable registration fee of $350 due at the time of contract signing which does apply to the final placement fee. The placement fee is based on a set percentage of the agreed upon annual salary for the hired employee PBD does provide a replacement employee within 90 days of hire at no additional charge.

We look forward to fulfilling your domestic placement needs.

First Name:

Last Name:

Children and their ages: (If applicable):

Contact Information:
*Please include at least one phone number.

Email:

Home Phone:

Work Phone:

Cell Phone:

Order is for:

Current staff consists of:

Tell us what you're looking for: (Select all that apply)

Childcare	Estate Manager/Majordomo
Estate Caretaker	Personal Assistant
House Keeper/Cook	Chef
House Keeper/Nanny	Butler
Housekeeping	Couple
Houseman/Handyman	Cook
Laundress	Chauffeur/Driver
Companion/Elderly Care	Security
Licensed Nurse	Airplane or Yacht Steward
Certified Nurses Aid	Governess
Male Attendant	Nanny
	Baby Nurse

Duties:

Skills Required:

Hours Required/ Any Other Particulars:

Other things you want us to know:

Home is:

Pets:

Dog

Both

Cat

None

Care for pets:

Type of Job:

Days off:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Full Time Salary Offered:
* Please select one range of compensation, full time salary or part time hourly/day rate.

Salary Range From:

Salary Range To:

Part Time Salary Offered:

Day Rate:

Hourly Rate:

House Car Available:

Job To Start:

How were you referred?

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