FIX PASSPORT

PICTURE OF
WORKER DOMESTIC SERVICE
STAFF DATA FORM
A. PERSONAL INFORMATION

1. Name ……………………………………………………………………………………………………………………….
(First) (Middle) (Last)

2. Date and Place of Birth ………………………………………………..…………………………………………………

3. Nationality ………………………………………… Hometown ……………………………………………….

4. Sex ………………………………………………….…. Marital Status ……………………….………………….

5. Mother’s Name ………………………………………………………………………………………………………………

7. Father’s Name ………………………………………………………………………………………………………………..

8. Bank Account No. …………………………………………………………………………………………………………..

9. Bank Name & Branch………………………………………………………………………………………………………

10. Mobile Number(s):……………………………………………………………………………………………………………

B. LOCATION / COVER AREA

Municipal/District: ………………………………………………………………………………………………
Suburb: ……………………………………………………………………………………………………………...

C. CONTRACT DURATION
A. 1 – 3 months B. 4 – 6 months C. 7 – 12 months

D. EFFECTIVE DATE
The effective date of your contract shall be …………………………………………………………

……………………………………….
SIGNATURE OF EMPLOYEE
 AGREEMENT

I (Mr./Mrs./Miss) ……………………………………………………………………… hereby receive the offer as a REVENUE

COLLECTOR with VOLTA WASTE LIMITED – Volta Region. I therefore agree to the terms and conditions
material to such offer and promise to be hard working and of good conduct.

Signature of Employee ……………………………………………… Date ………………………………………………

Postal Address………………………………………………………………………………………………………………………..

Signature & Name of Supervisor ……………………………………………………………………………………………

GUARANTOR

In case of any embezzlement of monies collected from client, I accept to take full charge of any certified
amount owed to the company and promise to defray full payment.

Signature & Name of Guarantor ………………………………………………………………………………………..

Signature & Name of witness ……………………………………………………………………………………………

FIX PASSPORT
PICTURE OF
GUARANTOR