Ref No: OS XHK ANN Type: EX HK

Expiration of Visa: Last date with last employer:

Personal Particular
Name:	ANN	Birth date:	1991 / 羊 / 天秤座
Age:	33	Civil status:	Single
Height:	5'1 inch	Weight:	54 kg
Religion:	Catholic	Language Spoken:	English
Philippine Address:	ZONE 9A BLK 3 BARANGAY FATIMA GENERAL SANTOS CITY
Family Background
Name of spouse:	JADE BINETEZ	His/Her Occupation:	SEAMAN
No of children:	3	Ages of children & Gender:	11 (Boy), 2 (Boy), 5 (Girl)
Age of mother:	64	Ages of father:
Your number in family:	5
No of Brothers you have:	3	No of Sisters you have:	1
Educational Attainment
High School Year 2009

My Special Skills and Experience
Domestic work	Experience	Special Skill
Newly born Care			Age: 0-12 months
Child Care			Age: 0 to 12 yrs old
Care of Special Child/Person			Age: 5yrs old
Care of Disabled Child/Person			Age:
Elderly Care (60 and above)			Age: 89
Child Tutoring
Cooking			Chinese      Western
Pet			Cat,dog,rabbit,bird

Employment Record
1.	Name of Employer:	KAREN			Duration:	2024-07-26 - 2025-04-16			Country-Area:	STANLEY
	Nationality:	CHINESE			No of Family Members:	5			No of years served:	9months
	No of Adult (18+):	3			No of elderly (65+):	1	Ages:	91
	No of Kids (0-17):	1	Ages:	8MONTHS	No of maids:				Size of house/flat:	850
	Reason of leaving:	NOT GOOD MY EMPLOYER
	Duties:	Taking care baby,dogs,house chores,cooking, marketing,cars wash
	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:

Employment Record
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?: Any
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.: I want to work again
15. Do you have Tattoos on your body? If yes, please specify.: Left shoulder little

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.