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(*) Pflichtfelder
Employment of a
Household data
Salutation
Frau
Herr
Last name
*
First name
*
Address
*
Telephone number (private)
*
Fax (private)
*
Telephone number (business)
*
Telephone number (business)
*
Mobile phone
*
E-Mail
*
Number of persons in your household
Number of children
Gender and year of birth of children
Are you a single parent?
Are both parents employed?
How many people in need of care live in your household?
Gender and year of birth of dependent persons
What does the person(s) in need of care suffer from?
Does a family member suffer from a particular disease?
yes
no
If yes, which one?
Do you have any pets?
yes
no
If so, which ones?
Knowledge of languages
Do you travel a lot?
yes
no
If so, with or without employees?
With employees
Without employees
What are the main destinations?
Will the employee often be alone?
yes
no
Do you live in a house or an apartment?
House
Apartment
Living space in m² / number of rooms
Should the employee live externally, i.e. independently provide accommodation?
yes
no
Make the following available to the employee(s)
an own room
a separate bathroom
a separate entrance
an own apartment
What's the neighbourhood like? Close to the village centre, city centre or rather remote?
Is your house/apartment easily accessible by public transport?
yes
no
Terms of employment
What will be the main tasks of the domestic worker?
Desired starting date
Working hours per week
Desired working hours/days
Number of vacation days
Salary expectations
To the candidate
Gender
Age
What language skills should the candidate have?
Should the candidate have a driving licence?
Should the candidate be a non-smoker?
yes
no
Which experiences/knowledge/activities are important for you and how? Please tick the appropriate boxes!
Cleanliness of the premises
sehr wichtig
important
unimportant
Cooking
sehr wichtig
important
unimportant
Shopping
sehr wichtig
important
unimportant
Laundry and wardrobe care
sehr wichtig
important
unimportant
Gardening
sehr wichtig
important
unimportant
Pet care
sehr wichtig
important
unimportant
Dealing with Antiques
sehr wichtig
important
unimportant
Childcare/experience in dealing with children
sehr wichtig
important
unimportant
Care of persons in need of care
sehr wichtig
important
unimportant
Representative tasks
sehr wichtig
important
unimportant
Chauffeuring
sehr wichtig
important
unimportant
Keep company
sehr wichtig
important
unimportant
Other
sehr wichtig
important
unimportant
Other desired knowledge/experience
Other remarks
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