Cass & Company :: Placements with Integrity

Candidates

Dear Prospective Nanny/Governess/Household Help/Eldercare/Estate & Corporate Job Applicants,

Thank you for contacting Cass Company LLC. We are a referral service for Nannies, Nanny/ Managers, Governess's, Household, Estate and Corporate help as well as Eldercare/Companions, Personal & Executive Assistants, Caretaker's & Estate Couples, Butler's Maids, Groundskeepers, Baby nurses, Tutors, Social Secretaries, Gentleman's Assistants, Ladies Assistant's, Nurses Aides, Baby Aide's and more.

Thank you for your interest in placement through Cass and Company, LLC we look forward to working with you.

Please complete, in full, the following application and submit when complete. In addition to the application, you need to submit the following:

  • A letter about yourself, including something about your life, where you were born, your childhood, what you have done with your life, what goals you may have, and why you would like to do the kind of job for which you are applying.
  • An enlarged, clear copy of your driver's license: E-mailed, Faxed or Mailed
  • Two recent, good and clear pictures of yourself: E-mailed, Faxed or Mailed
  • Three to five written references, letters of recommendation or list of references
  • Download and print the CORI Request Form: E-mailed, Faxed or Mailed
  • Download and print the Information Verification Release Form: E-mailed, Faxed or Mailed

This additional information increases your employment offers. We encourage you to complete the application and forward this additional information as soon as possible and we can start submitting your information on you to potential employers.

  • The health section must also be taken to your Primary Care Physician to be completed by your doctor and it's an employment physical requested by employers.

  • Lastly all Cass & Company job listings are confidential: If you are interviewing and accept a position by a Cass & Company Client you Must report it to Cass & Company and never give the client information to anyone, e.g. Friends, family, acquaintances etc. etc. A full placement fee will be due from you if you give client information that Cass & Company gives to you to a client; non-registered agent, or candidate and they accept/call the position. Otherwise there is never a fee charge to job applicants by Cass Company LLC.

Please send your information to Cass & Company LLC 60 State St. Suite 700, Boston , Ma 02109 or fax it to 1-888-453-2236, or E-mail it to jobs@casscompany.com We look forward to working with you.

Sincerely, Sara B. Cassinelli, MS, Administrator & The Staff of Cass & Company

Date Available:
Your Name:
Current Address:
City:
State, Zip:
Home Phone:
Best Time to Reach You:
Work Phone:
Fax:
Home Email:
Date of Birth:
SSN#:
Driver's License Number and State of Issue:
Marital Status:
Married Single Divorced Widowed
Other:
Maiden/Other first or last names used( Please List):
Can you make a one-year commitment?: Yes No
Character References (Priest, Minister, Rabbi, Co-Worker, Long-time Family Friend, etc):
Name Telephone # Relationship Dates
Do your own a car? Yes No
Would you bring your car with you to your new place of employment?
Yes No
Any Speeding or other tickets?
Yes No
Any accidents or moving violations Accidents?
Yes No
Any criminal record?
Yes No
Have you ever been arrested?
Yes No
Place of birth? (City, St.):
Are you registered with any other nanny agency at this time?
Yes No

Education and Training (Colleges, Technical Schools, Any other Courses, Chef, Hospitality School etc attended and attended/graduated from and other special training)
Types: HS=High School V/T=Vocational/Technical School CO =College O=Other Institution ST=Special Training

Type Name of Institution Dates Attended Degrees Attained
Are you CPR or First Aid Certified? Yes No
Can you cook?
Are you allergic to animals?
Are you comfortable working in a home with animals?
Do you swim?
Could you pull a child out of a pool who fell in?
Describe your personality and strengths:
Type of Position: (Check All you would Consider)
Nanny/N/Mgr/Babynurse
Household Manager
Housekeeper/Child Care
Companion/Elder Care
Chef/Cook
Personal Care Attendant/Nurses Aid
Duties of Position (Nanny only position)
Children's only

Childcare/Light Housekeeping

Children's laundry
General pickup
Clean up kitchen
Empty dishwasher
Keep bedrooms clean
Make beds
Make meals
Occasional errands
Driving children
Pick up toys
Pick up toy room
***Please check only job responsibilities that you will do: ***
HOUSEKEEPING:
Wash Walls Wash Windows Clean Bathrooms
Clean Kitchen Make Beds Polish Silver
Wash Clothes Wash Linens Wash Dishes & Pans
Hand Wash Clothes Iron Shirts Iron Linens
Dust Vacuum  
COOKING:
Gourmet Cooking Plain Cooking Family Serving
Prep Assistant Special Diet Cooking Family Cooking
HOUSEHOLD MANAGEMENT:
Supervise Staff Hire Staff Shopping
Event Planning Flower Arrangement Household Budget
Please check what you are willing to do from the list below:
Work on holidays if needed Work for a parent who works from home
Run errands & grocery shop Work evenings and weekends

Please answer the following questions if you are applying for a position where you might work in a home with children/ Even if you are not the primary caregiver. Please use a separate piece of paper if additional space is needed.

If Applicable: What age groups of children do you have experience with?
Newborn 6 months to 1yr. 1 to 2 years 2 to 4 5 to 7 7 to 12 Other ages:
Adult Care

Explain Where and When:
If you are applying for a childcare position, how many children have you cared for at one time?

Are there any limitations to the position you are seeking? (i.e. lifting, allergies etc, in school, available part time only, Husband/Wife /Children must relocate with me, must bring cats/dogs etc.)

What do you think it takes to be successful in a field like this?

Can you tell us a little bit about your family background?

Have you lived in any other state or country during your life other than the one you currently live in?
Yes No

If yes, please list all cities, states and countries:

If applying for a live-in position, do you have anything to consider, such as pets, Husband, boyfriend, children? If so, explain:

At what job were you the happiest?

What motivates you to put forward your best effort?

If you are leaving your current position, please explain why:

Do you ever get frustrated / angry? When:

Do you have any issues over working for people of different faiths, ethnicity, cultures, etc., other than your own?
Yes No

If you practice a religion, would you need certain days off for this?
Yes No

If yes what days, holidays etc.:

What are your interests and hobbies?:

Do you speak any other languages and, if so, which ones?:

Have you ever-experienced emotional problems? Yes No
Have you ever had counseling? Yes No
If yes, For what, when and are you still in counseling?:

Is there anything in your work/life balance that could create a problem or affect your work performance?:

What have been some of your successes?:

What are your immediate goals and long-term goals? (5 years & 10 years):

What would you list as three of your faults, and why are they negatives?:

Who will be your emergency contact(s) if you take a position through a Cass & Co. referral?:
Name Telephone Number Relationship

What is your policy on discipline?:

*** You are not required to answer the following two questions. However, due to the nature of our service, we ask that you consider the importance of the topic. ***

Have you ever been abused?: Yes No

Have you ever abused a child or anyone else?: Yes No

Cass & Co. jobs are one-year commitments and contracts are required to be signed. Is this OK with you?: Yes No

How did you hear about Cass & Co. LLC.?:

Health/Medical Information( Please complete)
Height
Weight
Do you have regular medical check ups? Yes No
When was your last check up?
Physician's Name
Physician's Address
Date of last T. B. test or chest X-ray
Have you had hepatitis prevention shots? Yes No
Are you a known hepatitis carrier? Yes No
Have you ever had hepatitis? Yes No
Do you have health insurance? Yes No
Insurance Company
Do you need health insurance? Yes No
List and explain any major operations/illnesses
Have you ever been told you have any of the following?:

Fainting or dizziness
Diabetes
High blood pressure
Chronic cough
Skin diseases
Frequent headaches
Hernia
Varicose veins
Serious physical or emotional traumas
Difficulty seeing/glasses/contact lenses

 Epilepsy or convulsions
Nervous or mental disorders
Low blood pressure
Allergies, asthma, wheezing
Deformities or amputations
Heart disease
Rheumatic fever or arthritis
Difficulty hearing/hearing aid
Please explain any questions that you answered yes to:
Are you (or have you been) treated for any neck or back disorder or injury?: Yes No
Do you take any prescribed medications? Please list :
Do you smoke?: Yes No If Yes, specify amount:
Do you drink?: Never Rarely Occasionally Socially Other

Do you take any illegal drugs?: Yes No
Would you be willing to take a drug test?: Yes No

 Specify amount and how often:
Have you changed (or been advised to change) occupations or residence because of health?: Yes No
Do you have any special medical considerations or physical limitations?: Yes No

If yes, please explain:
Do you have any body art or pierced places on your body?: Yes No

If yes where?:
WORK HISTORY : ( First is most current or last job)
Beginning with your present or most recent job, list all past employers. These employers may be contacted for reference purposes.
1. Name of Company Complete Address
Telephone Number Title

Supervisor's Name

 Employed From:
To
Starting Salary: Ending Salary:
Reason for Leaving: If still employed, may we contact? Yes No
2. Name of Company Complete Address
Telephone Number Title

Supervisor's Name

 Employed From:
To
Starting Salary: Ending Salary:
Reason for Leaving: If still employed, may we contact? Yes No
3. Name of Company Complete Address
Telephone Number Title

Supervisor's Name

 Employed From:
To
Starting Salary: Ending Salary:
Reason for Leaving: If still employed, may we contact? Yes No
4. Name of Company Complete Address
Telephone Number Title

Supervisor's Name

 Employed From:
To
Starting Salary: Ending Salary:
Reason for Leaving: If still employed, may we contact? Yes No
5. Name of Company Complete Address
Telephone Number Title
Supervisor's Name Employed From:
To
Starting Salary: Ending Salary:
Reason for Leaving: If still employed, may we contact? Yes No
6. Name of Company Complete Address
Telephone Number Title
Supervisor's Name Employed From:
To
Starting Salary: Ending Salary:
Reason for Leaving: If still employed, may we contact? Yes No
7. Name of Company Complete Address
Telephone Number Title
Supervisor's Name Employed From:
To
Starting Salary: Ending Salary:
Reason for Leaving: If still employed, may we contact? Yes No

Childcare/Household/Coupes, etc. Experience:
Please list all employment as well as volunteer work below. Please include the corporate experience as well any kinds of: Domestic/Estate/Management/Eldercare/Child Care (include ages), Corporate, Educational, and work related experience: For Elder's (their ages and list if their were any medical conditions involved( including Alzheimer's Disease) For Child Care: Please list: family/institution's name and telephone number, the dates of employment and whether it was babysitting, nanny care, daycare, teaching, etc.

Please only include positions not listed in general work history.

Type of employment Name of Family/Institution and telephone number Dates employed Job duties

Are there any childcare, or other household, corporate or related experiences that you are not including that you have worked or volunteered for?:
Yes No

If there are any childcare-related, household, corporate experiences you are omitting, please explain your reasons for this:

Privacy Policy:
Information collected by Cass & Company, LLC will be used only for the purpose of fulfilling our services which you have requested. Information that you provide to Cass & Company, LLC will not be given to any other parties without your written consent.

I agree not to refer to any client/Applicant (seeking a job) that I am referred to (Via Cass & Company LLC) or give information about, to any agency or person regarding a position Cass Company LLC tells me about. I understand that a fee will be due to Cass & Company LLC of the full placement fee for the client I have been given information about if I transfer/give information regarding Cass Company's property to other person(s)I and it will be my responsibility to pay fee for placement ( regardless if there is a hire ) that to: Cass & Company should I pass on a Name or information about a client/ candidate to others at that time (fees range from *$1250. to $15,000. or more [at this time}. I further understand that all clients' /candidates information is totally confidential and the property of Cass & Company LLC only, a Boston Company.

Check to agree and enter your name here for signature.