My Address Is:

My Phone #’s Are ________________________________________________

My Social Insurance or Social Security Number Is _______________________

My Email Address Is ______________________________________________

My Age Is ______ My Place of Birth Is ________________________________

I Am A Cigarette Smoker (Yes or No) ________________________________

I Hold A Valid Drivers License (Yes or No) ____________________________

I Will Provide A Police Clearance Letter (Yes or No) ____________________

I Want A Job As A (Nanny, Housekeeper, or) __________________________

I Want To Live-In or Out (or No Preference) ___________________________

_______________________________________________________________

I Wish To Earn $__________ .00 Weekly or Monthly ____________________

I Can Begin Working On The Following Date __________________________

I Prefer To Work (Give Choices Where) ______________________________

The Name Area Code & Phone Number of My Present Employer Is:

 The Type of Work I Do There Is:

The Name Area Code & Phone Number of My Last Employer Is:

The Type of Work I Did There Was _________________________________

______________________________________________________________

The Names Area Codes & Phone # of My Childcare References Are:

1. _____________________________________________________________

2. _____________________________________________________________

3. _____________________________________________________________

4. _____________________________________________________________

5. _____________________________________________________________

6. _____________________________________________________________

7. _____________________________________________________________ 

The Names Area Codes & Phone #’s of My Housekeeping References Are:

1. ______________________________________________________________

2. _____________________________________________________________

3. _____________________________________________________________

4. _____________________________________________________________

5. _____________________________________________________________

The Names & Phone #’s of My Nursing - Homecare References Are:

1. ______________________________________________________________

2. ______________________________________________________________

3. ______________________________________________________________

4. _____________________________________________________________

5. _____________________________________________________________

6. _____________________________________________________________

I Am Enclosing These (Copies of) Certificates, Documents, Photos, Etc:

________________________________________________________________

My Signature ________________________________ Date ________________

IF YOU RESIDE WITHIN THE MARITIME PROVINCES OF CANADA, THIS

APPLICATION MUST BE PRESENTED IN PERSON. OTHERWISE, YOU

MAY MAIL OR COURIER IT. PLEASE DO NOT SEND BY EMAIL OR FAX.

A LISTING WITH “AARON AGENCY” IS NO GUARANTEE OF EMPLOYMENT.