PERSONAL DATA

BRANCH: MANILA / ILOILO

Full Name: _______________________________________________

Address : _______________________________________________
_______________________________________________
Age

:___________________ Nationality:_________________

Date of Birth:_________________ Place of Birth:_______________

Religion :____________________ Marital status:_______________
Height (cm) :__________________

Weight (kg)

:____________

Complexion:__________________ ( Fair, Tanned, Dark)

FAMILY RECORD
Name of father: ___________________________________________
Age

: _______

Occupation:_________________

Name of mother:__________________________________________
Age

: _______

Occupation:_________________

Name of Husband: ________________________________________

Age

: _______

No of children : _______

Occupation:_________________
Age:

When you work abroad, who will take care your children:__________
Your position in family: ______
No of Brother(s):_______

Age:

No of Sister(s) : _______

Age:

NEXT OF KIN
Name

:____________________________________________

Contact

:____________________________________________

Address

:____________________________________________

OTHER PARTICULARS
Hobbies

: ____________________________________________

Language

: ____________________________________________

CODE:

EDUCATIONAL ATTAINMENT
Education Details

Name of School

Which course

From

Primary School
Secondary School
College/ University
Others
Have you been worked abroad before? ( Yes / No )
If Yes, give details below:
Employer Name

Duration

Country

Position

Salary

Reason of leaving

WORKING IN PHILIPPINE
Employer Name

Duration

Position

Salary

Reason of leaving

GENERAL INFORMATION (YES OR NO)

Are you willing to taking care of pet?
Are you willing to work in a house where there are pets?
Are you willing to work with non Christian family? (Eg: Muslim, Hindu, Buddhist)
Are you willing not to use hand phone/ mobile during working hour?
Are you willing to work without taking your off day?
Are you afraid of rats, spiders, and cockroaches?
Have you ever suffered from any serious illness?
Do you feel confident when left alone with children?
Can you look after children and does all the housework like cooking, laundering and cleaning by
yourself?
Do you aware that your employment contract is 2 years with your employer?
Do you understand stealing is criminal?
Are you aware you can not bring/ invite friends or relatives to the house of your employer?
Are you ready to be separated from your family during your employment in Malaysia?
Are you physically and mentally ready to work as a housemaid in Malaysia?
Does your parent/ husband allow you to work as a housemaid in Malaysia?

To

Do you have any friends or relatives work in Malaysia? ( Yes or No )

If Yes please give details
Name

Place of work in Malaysia

Telephone number

Relation

WORKING ABILITY (MULTIPLE )

Work

Willing

Not Willing

Experience

No Experience

Newborn baby
Toddler (1-5 years old)
Child care (6-12 year old)
Care of special child
Changing diapers
Special childs diet
Take care of babies during night time
Play with children
Look after elderly/ invalid (female)
Look after elderly/ invalid (male)
Drive private vehicle
Use of vacuum cleaner
Use if washing machine
Cooking
Laundry- hand wash
Ironing clothes
Care of pets
Gardening
Sewing and mending clothes
Kindly state briefly why you want to work abroad leaving your family and loved ones behind:
.
.
.
.

DECLARATION
I hereby declare that the information I have given above is to the best of my knowledge and belief true.
Should any of the above information be subsequently found to be incorrect, I may be dismissed from my
employer and repatriated at my own expense. I further declare that if I am employed I will not seek a
change of employer under any circumstances and I will faithfully serve my employer for the entire
duration of my employment contract.

_______________
(Date)

___________________
(Signature of application)

INTERVIEW RECORD
Date of interview:

H/P:

Name of interviewer:
Appearance:
Personality:
Complexion: white, yellow, brown, dark
English- spoken: Poor- Good : 1, 2, 3, 4, 5
Comprehension: Poor- Good : 1, 2, 3, 4, 5
Previous Employer abroad:

Remarks: prefer to take care new born/ children/ elderly