APPLICANT INFORMATION:

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Full Name

Email Address

Nationality

Choose your Gender: (Tap or Click to select)
--- Male Female

Education
Elementary Junior High School Senior High School College University

Religion

Date of Birth

Age

Choose your Marital Status: (Tap or Click to select)
Single Married Divorced Widowed Solo

Height (in cm)

Weight (in kg)

In the Family

Brothers/Sisters

Son/Age (separate by comma if more than one)

Daughter/Age (separate by comma if more than one)

Address

Phone Number (make sure to place the country code first)

LANGUAGE SKILLS:

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	Learning	Fair	Good
Mandarin
Cantonese
English

REMARKS:

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Availability		Location
Accept Share Room	Yes	No
Accept Share Job with other Helper	Yes	No
Holiday	Sunday	Saturday	Weekdays
Other

PREVIOUS WORK DUTIES 1:

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Country	Salary  $
Duration   From: To:		No. of people to serve
Reason for Leaving
Care of Babies	No. of Months	Care of Toddlers	No. of Years
Care of Children	No. of Years	Care of Elderly	No. of Years
Care of Disabled	No. of Years	Care of Bedridden
Care of Pets		Household Works
Car Washing		Gardening
Cooking		Driving

PREVIOUS WORK DUTIES 2:

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Country	Salary  $
Duration   From: To:		No. of people to serve
Reason for Leaving
Care of Babies	No. of Months	Care of Toddlers	No. of Years
Care of Children	No. of Years	Care of Elderly	No. of Years
Care of Disabled	No. of Years	Care of Bedridden
Care of Pets		Household Works
Car Washing		Gardening
Cooking		Driving

PREVIOUS WORK DUTIES 3:

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Country	Salary  $
Duration   From: To:		No. of people to serve
Reason for Leaving
Care of Babies	No. of Months	Care of Toddlers	No. of Years
Care of Children	No. of Years	Care of Elderly	No. of Years
Care of Disabled	No. of Years	Care of Bedridden
Care of Pets		Household Works
Car Washing		Gardening
Cooking		Driving

OTHER QUESTIONS:

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Can you cook Chineses Foods?	Yes	No
Do you eat pork?	Yes	No
Are you afraid of dog?	Yes	No
Are you afraid of cat?	Yes	No
Do you smoke?	Yes	No
Do you drink alcohol?	Yes	No
Have you any prolonged illnesses / undergone surgery?	Yes	No
If YES:
Will you accept job if employer's house has CCTV?	Yes	No