Ref No: OS MONIEE
Type: 1ST TIMER
Expiration of Visa:
Last date with last employer:
Personal Particular
Name: MONIE Birth date: 1990 / 馬 / 金牛座
Age: 35 Civil status: Married
Height: 5'2 inch Weight: 65 kg
Religion: Catholic Language Spoken:
Philippine Address: SITIO MANGKALAWAG,MILLAN.SIBUNAG,GUIMARAS
Family Background
Name of spouse: ANDREW C. GAITAN His/Her Occupation: LABORER
No of children: 2 Ages of children & Gender: 16 (Girl), 6 (Girl)
Age of mother: 75 Ages of father: 84
Your number in family: 9
No of Brothers you have: 4 No of Sisters you have: 5
Educational Attainment
High School Year 2008
My Special Skills and Experience
Domestic work Experience Special Skill
Newly born Care Age: 1yr old
Child Care Age: 5yr old
Care of Special Child/Person Age: 5yr old
Care of Disabled Child/Person Age: 8yr old
Elderly Care (60 and above) Age: 76
Child Tutoring
Cooking Chinese      Western
Pet Dog and cat
Employment Record
1. Name of Employer: GALBI FAMILY Duration: 2008-MAY - 2009-07 Country-Area: PHILIPPINES
Nationality: FILIPINO No of Family Members: 4 No of years served: 1YEAR
No of Adult (18+): 2 No of elderly (65+): Ages:
No of Kids (0-17): 2 Ages: 8MONTHS,3Y No of maids: 1 Size of house/flat:
Reason of leaving: SHE GOT PREGNANT
Duties: COOKING, CLEANING,WASHING CLOTHES , TAKING CARE OF THE KIDS
Remark:
2. Name of Employer: Duration: - Country-Area:
Nationality: No of Family Members: No of years served:
No of Adult (18+): No of elderly (65+): Ages:
No of Kids (0-17): Ages: No of maids: Size of house/flat:
Reason of leaving:
Duties:
Remark:
3. Name of Employer: Duration: - Country-Area:
Nationality: No of Family Members: No of years served:
No of Adult (18+): No of elderly (65+): Ages:
No of Kids (0-17): Ages: No of maids: Size of house/flat:
Reason of leaving:
Duties:
Remark:

Questionnaire Y是/N否
1. Are you willing to accept a weekday off or any day to be assigned by your employer?
2. Are you prepared to return home at a time set by your employer during your day off?
3. Can you promise not to ask salary in advance?
4. Are you willing to cut your hair short if your employer require?
5. Are you willing to take care and sleep with baby/children at night?
6. Are you willing to work with a stay-in employer?
7. Are you willing to work with another helper?
8. Can you promise not to use telephone without the permission of your employer?
9. Have you suffered from any serious illness? If yes, specify:
10. Can you drive vehicle?
11. Are you afraid of dog? Other pets?
12. Are you willing to follow the code of discipline drawn by your agency?
13. Do you smoke or drink (alcohol)?
14. Have you ever worked in Hong Kong as a domestic helper? if Yes, please declare in the Work History section.
15. Do you have Tattoos on your body? If yes, please specify.
Say something about your personality:
I AM A SIMPLY PERSON AND HARDWORKING

Personal Declaration:
I hereby certify that the above information is true and correct to the best of my knowledge and belief. I understand any false information may result to my future termination of my employment due to dishonesty.
MONIE
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傭工編號 Maid number: OS MONIEE
傭工姓名 Maid Name: MONIE
客戶姓名 Client Name*: Mr.    Ms.    Miss
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