STARKEY INTERNATIONAL INSTITUTE 360 Hour (Eight-Week ... · STARKEY INTERNATIONAL INSTITUTE. 1350...

29
STARKEY INTERNATIONAL INSTITUTE 360 Hour (Eight-Week) Certified Household Management Program Denver, Colorado (360 Curriculum Hours/On Site) REQUIRED ADMISSIONS MATERIALS $500.00 Tuition Deposit $2,800.00 On-Site Housing Fee (non-refundable deposit) Completed Admissions Packet including: o Completed and Signed Admissions Application o Typed 150 Word Personal Essay o Signed Terms and Conditions Agreement o Signed (with Notary present) Pre-Admissions Inquiry Release o Signed Enrollment Agreement o Goals Sheet & Technical Skills Self-Assessment o Current Resume o Educational Transcripts o Current Digital Photograph THE ENROLLMENT PROCESS CAN NOT START UNTIL THE ABOVE MATERIALS AND DEPOSITS ARE SUBMITTED

Transcript of STARKEY INTERNATIONAL INSTITUTE 360 Hour (Eight-Week ... · STARKEY INTERNATIONAL INSTITUTE. 1350...

STARKEY INTERNATIONAL INSTITUTE

360 Hour (Eight-Week) Certified Household Management Program

Denver, Colorado (360 Curriculum Hours/On Site)

REQUIRED ADMISSIONS MATERIALS $500.00 Tuition Deposit $2,800.00 On-Site Housing Fee (non-refundable deposit) Completed Admissions Packet including:

o Completed and Signed Admissions Application o Typed 150 Word Personal Essay o Signed Terms and Conditions Agreement o Signed (with Notary present) Pre-Admissions Inquiry Release o Signed Enrollment Agreement o Goals Sheet & Technical Skills Self-Assessment o Current Resume o Educational Transcripts o Current Digital Photograph

THE ENROLLMENT PROCESS CAN NOT START UNTIL THE ABOVE MATERIALS AND DEPOSITS ARE SUBMITTED

STARKEY INTERNATIONAL INSTITUTE

1350 Logan Street, Denver, CO 80203 Phone: 303-832-5510 Fax: 720-420-6538 Email: [email protected]

Approved and Regulated by the Colorado Department of Higher Education, Private Occupational School Board

ADMISSIONS APPLICATION Date School Term Housing

Full Legal Name

Current Address

City State Zip

Previous Address

City State Zip

Home Phone Cellular Phone Business Phone

May We Call You At Work?

Email Address

PERSONAL INFORMATION

Birth Date Birth Place

US Citizen Yes No If No, Then Work Permit Number

Passport Number Social Security # Driver’s License # State

Marital Status: Partnered Single Married

Separated Divorced Widowed

If Married or Partnered, what is your spouse’s occupation?

Do you have any children? Yes No If yes, please list their ages: Have You Ever Been Convicted of a Felony? Yes No If yes, Please Explain:

Have You Ever Been Convicted of a DUI? Yes No If Yes, Please Explain

Is there any aspect of your physical or mental health, or any other issue in your personal life, that would interfere with your ability to perform the essential functions of this position safely and effectively? Yes No If Yes, Please Explain

Do You Drink Alcohol? Yes No Do You Use Tobacco? Yes No

EMERGENCY CONTACT

Name Relationship to You

Address

City State Zip

Home Phone Number Cellular Phone Number Work Phone Number

MILITARY SERVICE Branch Dates of Service Rank Rate Enlistment Status Reserve Status Did You Receive An Honorable Discharge? Yes No If No, Please Explain

Commander Name: Address:

Telephone Number:

EDUCATION

Name

Address Years

Attended Graduation

Date Degree Major

High School

University

University

Trade School

Trade School

Trade School

Career Training / Occupational Training

Other Education

Do You Speak Any Other Languages? Please list language and proficiency.

COMPUTER PROFICIENCY Can You Type? Yes No How Fast? Program Beginner Intermediate Expert Don’t Know

MS Office Suite MS Word MS Excel MS Outlook Internet Explorer

List Other Computer Programs With Which You Are Familiar and Level of Proficiency:

EMPLOYMENT HISTORY (Begin with your MOST RECENT work experience)

FAILURE TO COMPLETE THIS SECTION IN DETAIL WILL RESULT IN NON-ACCEPTANCE Employer Name Dates of Employment

Supervisor Name

Employer Address Phone Number

Gross Salary Position Title Duties and Responsibilities

Reason For Leaving Employer Name Dates of Employment

Supervisor Name

Employer Address Phone Number

Gross Salary

Position Title Duties and Responsibilities

Reason for Leaving Employer Name Dates of Employment

Supervisor Name

Employer Address Phone Number

Gross Salary

Position Title Duties and Responsibilities

Reason for Leaving

EMPLOYMENT HISTORY CONTINUED… Employer Name Dates of Employment

Supervisor Name

Employer Address Phone Number

Gross Salary

Position Title Duties and Responsibilities

Reason for Leaving Employer Name Dates of Employment

Supervisor Name

Employer Address Phone Number

Gross Salary

Position Title Duties and Responsibilities

Reason for Leaving Employer Name Dates of Employment

Supervisor Name

Employer Address Phone Number

Gross Salary

Position Title Duties and Responsibilities

Reason for Leaving A Starkey representative will call current and previous employers, encompassing the past 10 years to interview and verify employment. PLEASE CONTACT previous employers to make them aware of the forthcoming call.

PERSONAL REFERENCES

DO NOT LIST RELATIVES OR FORMER EMPLOYERS

(Please contact your references and let them know they will be contacted) Name Address

Years Known Relationship Home Phone

Cellular Phone

Occupation Business Phone

Name Address

Years Known Relationship Home Phone

Cellular Phone

Occupation Business Phone

Name Address

Years Known Relationship Home Phone

Cellular Phone

Occupation Business Phone

Name Address

Years Known Relationship Home Phone

Cellular Phone

Occupation Business Phone

PROFESSIONAL REFERENCES (Please contact your references and let them know they will be contacted)

Name Address

Years Known Title Home Phone

Cellular Phone

Occupation Business Phone

Name Address

Years Known Title Home Phone

Cellular Phone

Occupation Business Phone

Name Address

Years Known Title Home Phone

Cellular Phone

Occupation Business Phone

Name Address

Years Known Title Home Phone

Cellular Phone

Occupation Business Phone

PERSONAL ESSAY

In the space below, or on a separate sheet of paper, type an essay (150-word minimum) in your own words explaining 1) why you wish to receive the training 2) how you will benefit from this training and 3) what you can

contribute to the Private Service Industry.

TERMS AND CONDITIONS Please Read and Sign The Following:

I have read the terms and conditions of acceptance in the Starkey International Institute for Household Management, Inc. (SII) catalog and agree that if accepted and registered, I will abide by them. I understand that it is my responsibility to acquire the necessary application materials to complete my file for review and will update my file with any changes in employment. I certify that answers provided by me on this application is true, correct, and complete to the best of my knowledge and that no facts have been omitted.

I authorize SII to obtain an investigative report containing information about me, including information obtained through personal interviews with my neighbors, friends and acquaintances. This report may include information as to my character, general reputation, personal characteristics, mode of living, my reliability, credit worthiness, employment history, and education (including school transcripts). I authorize SII to access my consumer credit report. I understand that any negative information obtained in these investigations may affect, as allowed by law, my admission eligibility, but that all information will be evaluated in light of my age at the time of an incident, the nature of the incident, and my mode of living since the incident occurred. I understand that completion and processing of this application does not obligate SII to admit, hire or place me in any position.

In the event that I am admitted, I authorize SII to distribute, copy and transmit, as allowed by law, the information obtained about me to potential employers for the purposes of securing potential employment for me, and to act as my agent in seeking such employment possibilities, understand that the stated placement policy of Starkey International Institute for Household Management, Inc. is that of full disclosure and that any information about me, whether provided by me or obtained through legal, authorized investigative means, may be provided to any prospective employer to whom I am presented for possible employment. I further understand that such information may, as allowed by law, prevent me from obtaining employment in the household management / household professional industry.

I acknowledge that the Starkey International Institute for Household Management, Inc. does not guarantee employment to me, and that by signing this form I acknowledge a full understanding of the full disclosure policy and its potential ramifications on my future employment.

Applicant’s Signature Date

Applicant’s Printed Full Legal Name

All materials and deposits on the Admissions Checklist are mandatory. Your completed Acceptance Packet, including this Application, is imperative to

the Acceptance Process. You are responsible for the completion and submission of all required documentation. Failure to do so will result in a

delay to the Acceptance Process.

STARKEY INTERNATIONAL INSTITUTE Pre-Admissions Inquiry Release

In connection with my application for enrollment in the Starkey International Institute for Household Management, Inc. (SII), I understand that investigative background inquiries are to be made on myself including, but not limited to, personal interviews with my neighbors, friends, previous employers and acquaintances. Further, I understand that you will be requesting information from various Federal, State, and other agencies that maintain records concerning my past activities and may access information relating to my credit, criminal, driving, civil, worker’s compensation and other experiences. These reports may include information as to my character, general reputation, personal characteristics, reliability, and education (including school transcripts). I authorize, without reservation, any party or agency contracted by SII to furnish the above-mentioned information. I hereby consent to your obtaining the above information from any licensed agents or services. I understand to aid in the proper identification of my files or records the following information is necessary.

Full Legal Name

Maiden Name Aliases

Current Address

City State Zip

Home Number Cellular Number Business Number

Social Security Number Date of Birth

Driver’s License Number State

Applicant Signature Date Subscribed and affirmed, or sworn to before me, in the State of , County of , This day of , 20 , by (Applicant), who executed this form in my presence and presented the identification described above.

My Commission Expires:

Notary Public Signature

Notary Public Printed Name Notary Seal:

STARKEY INTERNATIONAL INSTITUTE

Non-Disclosure & Non-Compete Agreement for Students

THIS AGREEMENT is made this _ day of , 20 by and between Starkey International Institute for Household Management, Inc., a Colorado Corporation, with offices at 1350 Logan St., Denver, Colorado 80203 (hereinafter "SII"), and an individual, who resides at _ (hereinafter "Student").

1. WHEREAS, SII is in the business of training and placing people to provide high quality personal household

services for their clients, and

2. WHEREAS, Student desires to enroll in SII’s training program and SII has accepted Student for such training, and

3. WHEREAS, during the course of such training, Student may receive access to information and trade secrets

which, if disclosed or used in competition with SII, would place SII at a competitive disadvantage or tend to remove SII's competitive advantage in the household services industry (hereinafter "Confidential Information"), and

4. WHEREAS, the parties wish to clarify the terms and conditions under which the Confidential Information

will be disclosed to Student.

NOW THEREFORE, in consideration of the mutual promises outlined below, the sufficiency of which is hereby acknowledged, the parties agree as follows:

1. SII agrees to give Student whatever access to Confidential Information is necessary to train Student.

a. Confidential Information includes, but is not limited to, client names, student names, placement

applicants, investigative and reference checking, written materials, texts, documents, software, and ideas and concepts for new or existing work products, whether revealed in formal or informal discussions.

b. The Information will be labeled "Confidential" or SII will state to Student that the Information is confidential at the time of its disclosure.

c. Confidential Information does not include information and data which now or hereafter is generally known or available from other sources without obligation concerning their confidentiality.

2. Student agrees

a. To use Student's best efforts i. To protect the Confidential Information

ii. To use the Confidential Information only for purposes of Student’s training and subsequent employment in the household services industry

iii. To refrain from copying the Confidential Information on paper or converting it to electronic media - through scanning, video, or re-keying – and

iv. To make no further disclosure of the Confidential Information without the express written consent of SII.

b. To return all Confidential Information in the Student' possession upon leaving the training of SII for any reason, unless permitted to keep it by SII.

c. To indemnify and hold harmless SII, its agents, employees and representatives, from any and all claims brought against SII resulting directly or indirectly from any breach of this Agreement by Student.

3. Student acknowledges and agrees that, in the event of any breach of this agreement, SII might be irreparably

and immediately harmed and unable to be made whole by monetary damages. It is accordingly agreed that SII, in addition to any other remedy to which it may be entitled at law or in equity, will be entitled to seek an injunction or injunctions to remedy breaches of this Agreement and/or to compel specific performance of this Agreement. Student further agrees that monetary damages include costs and reasonable attorney’s fees.

4. General provisions:

a. This Agreement may be executed in counterparts, each of which shall be deemed an original and

all of which together shall constitute but one and the same instrument. b. This Agreement sets forth the entire agreement among the parties. No provision of this

Agreement can be altered, amended or revoked except by an instrument in writing signed by the parties.

c. The laws of the State of Colorado in all respects shall govern this Agreement, and should any dispute arise between the parties, venue shall lie in the State of Colorado.

d. In the event that any provision of this Agreement is determined by any court of competent jurisdiction to be illegal or unenforceable, such illegal or unenforceable provision shall be severed, and the remainder of this Agreement shall continue in full force and effect.

e. This Agreement will inure to the benefit of the heirs, successors, and assigns of the parties. f. Any failure to enforce the provisions of this Agreement shall not constitute a waiver of future

enforcement actions by any party.

IN WITNESS WHEREOF and in acknowledgment of their complete understanding of the nature and intent of this Agreement, the parties have placed their hands on the date first above written.

Student Signature Date

Student Name Printed

Director of Admissions Date

Enrollment Agreement Page 1 of 4 Starkey International Institute

STARKEY INTERNATIONAL INSTITUTE 1350 Logan Street, Denver, CO 80203 Phone: 303-832-5510 Fax: 720-420-6538

Email: [email protected] Approved and Regulated by the Colorado Department of Higher Education, Private Occupational School Board

360 Hour (Eight-Week) Certified Household Management Course Denver, Colorado (360 Residential/Curriculum Hours) Start Date:

Enrollment Agreement Personal Information and Identification

Full Legal Name

Address

City State Zip

Home Number Cellular Number Business Number

Birth Date Place of Birth

Tuition, Fees and Other Expenses Tuition and Fees Subject To Cost Change

ITEM RATE

Admissions Deposit Fee (Due at time application is received) $500.00 Tuition: 360 Hour (8 week) Certified Household Management Program

The Following are Non-Refundable:

Books and other Materials (Software included)--------------------------------

Meals-----------------------------------------------------------------------------------

Field Trips and Specialty Classes----------------------------------------------------- *These items are not optional and cannot be deleted, substituted for or privately provided. Each item will require participation from the student and will count toward graduation and certification through Starkey International Institute for Household Management.

Non-Refundable On-Site Housing Deposit (Due at acceptance)

$9,500.00

$747.50

$2,650.00

$598.00

$2,800.00 TOTAL DUE (With Housing in the Mansion) – First Come First Serve Basis TOTAL DUE (With-Out Housing in the Mansion)

$16,795.50

$13,995.50

Enrollment Agreement Page 2 of 4 Starkey International Institute

Type of Instruction: Classroom (Theory, Practical and Application) Candidacy: Enrollment Agreement is for 360 Hour (8 week) Certified Household Management

Program I have reviewed the current catalog for the course and understand the hours and content.

Financial: The aforementioned cost of attending the Institute and the method of payment are subject to the terms and refund policy stated in this agreement. Indicate how the Balance Due is to be paid: _

Intent of Payment:

Full Payment 21 days prior to start date of course (Check, Money Order, Cashier’s Check, Debit or Credit Card) Approved Sponsorship (Reviewed on a Case-by-Case Basis) Other; Please Ex

By signing this contract, the student agrees to pay SII the total stated tuition and fees. SII agrees to provide the occupational training in accordance with the provisions of the current catalog. Payment of all monies due 21days prior to the start date of the course shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements and when all financial obligations to the school have been met, SII will award the educational credentials for this course to the student. The student and the school understand that this enrollment agreement, which includes the refund policy, may not be amended except in writing signed by both parties.

Applicant Signature Date

Director of Admissions Date

The Student agrees to comply with SII rules and regulations during his/her program of study, and SII has the privilege of cancelling this agreement and expelling the Student in the event of the Student’s failure to comply with the rules and regulations as stated in the current catalog. The Student may also be terminated for failure to maintain a satisfactory grade point average, excessive absences, or non-payment of tuition or other costs. To be eligible for graduation and to receive a certificate, the Student must complete all courses, including theory and laboratory instruction with an overall grade point average of at least 2.0 and be current in all financial obligations to the Institute. If the Student fails to complete satisfactorily any course due to excessive absences or deficient grades, then he/she will be allowed to repeat such course at the next available offering. SII reserves the right to select which courses will be offered each term and to substitute other courses for those listed in the program of study, which do not substantially alter the integrity of the program. In accepting applications, SII assumes the obligation of furnishing a complete program, teachers, equipment, laboratories, classrooms, and other facilities necessary for teaching this program at a stated offered tuition cost for the program as inserted previously in this agreement. In the event SII is unable to perform any of its obligations under this agreement by reason of fire, strike, work stoppage, riot, utility failures or shortages or damages by the elements, Acts of God, or of any unavoidable casualty, SII shall not be responsible for damages caused by delay or failure to perform hereunder, provided said delay does not exceed 90 days and the Institute evidences positive efforts every 30 days to reactivate SII. Refunds at any time will be made only in accordance with the refund policy of the Institute as printed below:

REFUND POLICY

Students not accepted by the school and students who cancel this contract by notifying the school within three (3) business days prior to the class start date are entitled to a refund of tuition and fees paid except the cancellation fee of $150.00. Students who withdraw after three (3) business days but before commencement of classes are entitled to a refund of tuition and fees paid except the cancellation fee of $150.00. In the case of students withdrawing after commencement of classes, the school will retain a cancellation fee, the non-refundable charges, plus a percentage of tuition and refundable fees based upon the percentage of contact hours attended as described in the table below. The refund is based on the last date of recorded attendance. The housing deposit is non- refundable.

Student is Entitled to Upon Withdrawal/Termination

Refund Of

Within first 10% of program

90% less $150.00

After 10% but within first 25% of program

75% less $150.00

After 25% but within first 50% of program

50% less $150.00

After 50% but within first 75% of program

25% less $150.00

After 75%

no refund

Student may cancel this contract at any time prior to close of the third business day after signing this contract. The official date of termination for refund purposes is the last date of recorded attendance. All refunds will be made within 30 days from the date of termination. All other refunds made, regardless of reason, will be made within 30 days from the date of determination. All other charges are non-refundable. The policy for granting credit for previous training shall not impact the refund policy. Policy regarding postponement of start date and the effect on student's rights to a refund: “Postponement of a start date, whether at the request of the school or the student, requires a written agreement signed by the student and the school. The agreement must set forth: o Whether the postponement is for the convenience of the school or the student, and: o A deadline for the new start date, beyond which the start date will not be postponed.

If the course is not commenced, or the student fails to attend by the new start date set forth in the agreement, the student will be entitled to an appropriate refund of prepaid tuition and fees within 30 days of the deadline of the new start date set forth in the agreement, determined in accordance with the school's refund policy and all applicable laws and rules concerning the Private Occupational Act of 1981. The student will receive a full refund of tuition and fees paid if the school discontinues a course/program within a period of time a student could have reasonably completed it, except that this provision shall not apply in the event the school ceases operation. A person claiming pecuniary loss as a result of a deceptive trade sales practice, pursuant to Section 12-59-117 of the Colorado Revised Statutes, by a school or agent shall first exhaust all complaint and appeals processes available at the school. If the person’s complaint is not resolved to the person’s satisfaction, the person may file with the board a written complaint against the school or agent. A person shall submit all said claims in writing by certified mail to: Starkey International Institute, Claims Department, 1350 Logan Street, Denver, Colorado 80203. Complaints, which cannot be resolved by direct negotiation between the student and the school, may be filed with the Division of Private Occupational Schools of the Colorado Department of Higher Education, 1560 Broadway, Suite 1600, Denver, Colorado 80202, (303)866-2723, or online at http://highered.colorado.gov/dpos. There is a two-year limitation on the Division taking action on student complaints. The Division shall not consider any claim that is filed more than two years after the date the student discontinues their training at the school.

Enrollment Agreement Page 3 of 4 Starkey International Institute

The Institute makes a guarantee neither for placement following training nor of credit transfer. The parties executing this Enrollment Agreement hereby acknowledge that they have read, understood and received a copy of this agreement, the Institute application and current school catalog.

Applicant Signature Date

Director of Admissions Date

Enrollment Agreement Page 4 of 4 Starkey International Institute

STARKEY INTERNATIONAL INSTITUTE

Goals I Expect to Accomplish During Training

STUDENT NAME 1

2

3

4

5

6

7

8

9

10

20

STARKEY INTERNATIONAL INSTITUTE Technical Skills Self-Assessment

STUDENT NAME The following is a Technical Skills Self–Assessment Matrix. This Matrix will be discussed in various formats during the course of the four and eight week programs.

Taking the service standards listed on the left side, please evaluate yourself on a scale of one to ten (one being low ability and ten being high ability). This form is a self-assessment tool to determine where you see your present skills now, and then you will re-assess the same skills at the end of the program.

SERVICE STANDARDS RATE YOUR SKILLS

Management Skills Administrative Skills Organization Skills Computer Proficiency Housekeeping Knowledge Cooking / Culinary Skills Clothing / Personal Care Skills Entertaining Skills Event Coordination Skills Property / Grounds Skills Household Maintenance Skills Household / Property Security Skills Child / Elder / Pet Care Skills Travel / Concierge Skills Vendor Management Skills Construction Contract Mgt Skills

TOTAL POINTS

Please return this form with your completed admissions application.

21

Celebrating 30 years of Service as an Expertise

Private Service Professional Application

The purpose of Starkey & Associates (SA) is to place trained and/or experienced professionals in private homes, corporations, hotels and other hospitality-related industries. Starkey's goal is to help set standards for excellence in the field. For our Starkey Graduates and industry applicants, we act as an agent in the placement process. Since we do not charge you for these placement services, we reserve the right to place only those individuals who we deem meet our criteria of excellence.

Our placement process includes several phone and/or personal interviews, a completed household professional application and a routine investigative search on your background, both professional and personal. You must have at least five consecutive years of job references to attest to your professional experience working in private residences if you would like to be placed as a Household Manager. If you are a Starkey trained graduate, you must have at least three references that can attest to your experience and professionalism in related industries. Other criteria do exist for particular positions. Please note that the information in Sections 4-8 of this application is not used in determining your eligibility for employment. By law, you cannot be required to answer any of the questions in Sections 4 - 8 until after you have been placed, but providing this information will be useful in placing you.

If you would like SA to act as your agent, please print clearly and return this completed application to us. Though this is not a requirement, we request that you submit a photograph of yourself for your file, as our clients like to review personal photographs of our placement candidates.

Failure to complete this application in complete detail will delay the placement process for you.

22

Contact Information

Today's Date:

Name:

Best time to call:

Current Address:

Current Daytime Ph#:

Current Email Address:

Alternate Phone Number:

23

Section 1: Position Preference

Position applying for: Household Manager Estate Manager Butler Companion Elder- care manager

(Please indicate combination roles) Household Chef Household Couple Personal Assistant

Other (specify):

Type of Position: Live-In Live-Out Will consider both

Years Experience in a Private Household:

Date you are available for employment: Salary expectation:

City/State Desired: 1st Preference:

2nd Preference:

Open

24

Section 2: Referral Information

How did you hear of Starkey? Publication (please specify):____________________________________

Personal referral Internet Other:______________________________________________

Have you previously applied with us? Yes No If yes, when did you apply?

Have we previously placed you? Yes No

If yes, indicate name of the household,

your position, and the dates:

Section 3: Transportation Information

Do you have a car? Yes No Make: Type: Year:

Insurance company's name and your policy number:

(Please provide a copy of your proof of insurance.)

Can you drive a standard

Transmission (stick)? Yes No

Do you need

transportation provided? Yes No

25

Section 4: Personal Information

Birth date: Birthplace:

U.S. Citizen? Yes No If no, your work permit number:

Passport? Yes No If yes, your passport number:

Social Security #: Drivers License: State:

Marital Status: Single Married Separated Divorced Widowed How long?

Do you have any children? Yes No If yes, please list their ages:

Are you willing to work in a home with a child? Yes No What age(s)?

Do you know how to swim? Yes No How well: Average Above Average Below Average

Have you ever been convicted of a Driving Under the Influence charge?

Yes No If yes, please explain:

Any moving violations? Explain:

26

Have you ever been arrested or convicted for theft, embezzlement, or any other criminal activities? (either misdemeanor or felony)

Yes No If yes, please explain:

Have you ever been arrested or convicted for having improper sexual or physical contact with a child?

Yes No If yes, please explain:

Section 5: Physical Information

Height: Weight: Date of last physical exam: Last T.B. test:

Are you willing to take a physical examination prior to employment? Yes No

Do you have any physical limitations that might interfere with doing the job for which you are applying?

Yes No If yes, please explain:

Do you have any allergies (food, pets, chemicals, medications, dust)?

Yes No If yes, please explain:

Have you ever filed, or had filed for you, a workmen's compensation claim?

Yes No If yes, please explain:

Do you drink alcohol? Yes No

Do you smoke? Yes No If yes, can you work without smoking? Yes No

27

Section 6: Medical Skills and Certifications

If you are qualified, licensed, or certified in any health, medical, or related field (i.e. nutrition, medical assistant, nurse's aid, CPR, lifesaving, etc.) please indicate here. Be sure to list the skill, license/certificate number, date of qualification/issue, and the expiration date:

Signature Date

Please print your name here

Required Application Ma terials: (to be returned with this application)

1. Completed and signed Household Professional Application, including a personal statement.

2. Current resume

3. Transcripts: Official High School and/or GED diploma; Official College transcripts in a sealed envelope from attended institution (must not be stamped “Student Copy”). This may be sent directly from the institution to your SA placement consultant.

4. Three letters of reference (on letterhead): Please Use Former Employers Only, NO RELATIVES OR

FRIENDS.

5. Copy of your Proof of Automobile Insurance card or policy.

6. Copy of your Drivers License and Social Security card.

7. Signed SA Pre-Employment Inquiry Release authorization form.

8. Signed Department of Justice Employment Eligibility Verification Form I-9

9. Proof of computer skills (i.e. certificate if available).

10. Recent photograph, preferably in business attire (optional).

28

STARKEY INTERNATIONAL INSTITUTE

Dress Code

CERTIFIED HOUSEHOLD MANAGERS 4 & 8 WEEK PARTICIPANTS

As much as possible, we try to relate your dress code to actual job situations in Household Management. Occasionally persons relax this dress code once placed and quickly begin to lose their professional edge. Begin to practice the discipline now.

Below is the required clothing you will need while attending the Starkey International Institute for Household Management.

Gentlemen DAILY CLASS ATTIRE

Slacks - Khaki (suggest a minimum of 3)

Shirt - Long sleeved white straight-collared shirt is mandatory (no Oxford shirts with button down collars).

Shirt (Daily Graces) - Short sleeved white polo style shirt (suggest a minimum of 2)

o No patterns or designs,

o A small logo over the left or right upper area is acceptable.

o This is worn with khaki slacks.

Neckwear - Conservative necktie

Blazer - Solid navy blue

Shoes - Brown (must be able to polish)

o Please Note: All shoes must be non-scuff and have soft soles.

The intent is to create as little noise as possible while walking on hardwood floors or during serving at formal dinner exercises.

Belts – Brown

8 week students – P lain white Chef’s jacket

Ladies

Slacks/Skirts - Khaki (suggest a minimum of 3)

o If desired women may wear mid-calf length, khaki skirts.

Shirt – Long sleeved white

o Must be tucked in and ALL buttons except for top button must be fastened.

o No short sleeved or sleeveless tops or dresses

o No blouses

29

Neckwear – Small conservative neck scarf in a solid color or conservative pattern may be worn.

Shirt (Daily Graces) - Short sleeved white polo style shirt (suggest a minimum of 2)

o No patterns or designs

o A small logo over the left or right upper area is acceptable.

o This is worn with khaki slacks.

Blazer - Solid navy blue

Shoes - Brown (must be able to polish)

o Please Note: All shoes must be non-scuff and have soft soles.

The intent is to create as little noise as possible while walking on hardwood floors or during serving at formal dinner exercises.

Belts – Brown

8 week students – P lain white Chef’s jacket

FORMAL ATTIRE (REQUIRED) Gentlemen & Ladies Slacks – Black

o Plain - no print or flared bottoms o Pleated front is acceptable.

Shirt - Long sleeved white straight-collared shirt (no Oxford shirts with button down collars). o Please wear undershirts gentlemen – preferably round neck with sleeves.

Vest - Black o Plain - no patterns, designs or silk back. o Poly-blend

Shoes - Black

o Non-scuff rubber soled Socks – Black or nylons for the ladies Bow Tie -Black

o Plain - no patterns or designs

Gentlemen INTERVIEW ATTIRE

Conservative styled suit - A dark two-buttoned, three-buttoned or double-breasted is acceptable. Military Enlisted Aide - Should wear their uniform as appropriate for all interviewing occasions.

Ladies Conservative styled suit - A dark two-buttoned, three-buttoned suit is acceptable

o No short sleeved or sleeveless tops or dresses

30

o Please be conscious of ‘over-stylish shoes’.

o No excessively high heels or ‘statement makers’

Military Enlisted Aide - Should wear their uniform as appropriate for all interviewing occasions.

GRADUATION ATTIRE Civilian Graduates should wear their interview attire for the graduation ceremonies. All military persons are required to bring their uniform to wear at graduation ceremonies.

PERFUMES AND OTHER SCENTS REFRAIN from using any perfumes or scents while in class or while serving at the formal dinner

exercises.

o This can be uncomfortable for people with allergies. o This should also be a priority when considering entering private home service, as you would

most likely be asked to forego such cosmetics in the work place.

JEWELRY & GROOMING Starkey International requests that you take a moment to review, understand and subsequently comply with our jewelry policies:

Gentlemen Jewelry

o Limit to rings, wristwatches or inconspicuous necklaces o If your jewelry collection includes items or visible piercing in other areas, you are asked to

refrain from wearing these during class times or entertaining exercises. Hair - should be conservatively combed, trimmed, and styled. Facial Hair - avoid

Ladies Jewelry

o Limit to conservative earrings worn only at the bottom of the ear lobe o A conservative necklace or rings o If your jewelry collection includes items or visible piercing in other areas, you are asked to

refrain from wearing these during class times or entertaining exercises Hair - Long hair should be pinned back and off shoulders Make-up - should be worn in a conservative manner