South China - Application Form
Last Visa
Full Name
*
Please upload your picture (Tidy and Neat with good smile)
Please upload your passport / other certificate if available)
*
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of
Your Selfie
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PERSONAL PARTICULARS
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Answer
Age
Date of Birth (mm/dd/yyyy)
Place of Birth
Nationality
Marital Status
Religion
Weight(kg)
Height(cm)
FAMILY BACKGROUND
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Number
Age
Children
Brother(s)
Sister(s)
CORRESPONENCE
*
Answer
Address Line 1
Address Line 2
Contact Number (Whatsapp, make sure we can contact you)
EDUCATIONAL ATTAINMENT
*
School Name
From (yyyy) to (yyyy)
Elementary
High School
College / University & Subject
Other Training
1. DOMESTIC EMPLOYMENT HISTORY
Answer
Location
Salary
No. of Served
From (yyyy) to (yyyy)
Size of House (sq.ft)
Reason of Leave (Finished / Break / Terminated) and why?
Duties
Duties
How Many? & Age
Care of newborn babies
Care of Children
Care of Elderly
Care of Disabled Person
Care of pets
General Housework
Hand Washing Clothes
Marketing
Gardening
Car Washing
Chinese Food
Western Food
Other
Shared Room
2. DOMESTIC EMPLOYMENT HISTORY
Answer
Location
Salary
No. of Served
From (yyyy) to (yyyy)
Size of House (sq.ft)
Reason of Leave (Finished / Break / Terminated) and why?
Duties
Duties
How Many? & Age
Care of newborn babies
Care of Children
Care of Elderly
Care of Disabled Person
Care of pets
General Housework
Hand Washing Clothes
Marketing
Gardening
Car Washing
Chinese Food
Western Food
Other
Shared Room
3. DOMESTIC EMPLOYMENT HISTORY
Answer
Location
Salary
No. of Served
From (yyyy) to (yyyy)
Size of House (sq.ft)
Reason of Leave (Finished / Break / Terminated) and why?
Duties
Duties
How Many? & Age
Care of newborn babies
Care of Children
Care of Elderly
Care of Disabled Person
Care of pets
General Housework
Hand Washing Clothes
Marketing
Gardening
Car Washing
Chinese Food
Western Food
Other
Shared Room
NON-DOMESTIC EMPLOYMENT HISTORY
Answer
Location
From (yyyy) to (yyyy)
Salary
Position
Reason of Leave (Finished / Break / Terminated) and why?
Please answer the following questions
Answer
What kind of food you DON’T eat?
Do you have tattoos? If yes, where is it?
Are you willing to take care of dog, cat or other pets?
Are you willing to share job with other helper?
Are you willing to take day off on weekdays or Saturday?
Are you taking any medications? What is it?
Have you ever suffered any diseases / allergy? What and when was it?
Have you ever been convicted of a criminal offence in a court of law?
Capabilities
Tick if you able to perform
Care of Infant
Care of Child
Care of Elderly
Care of Pet
Care of Disable Person
Care of Bedridden Person
General Housework
Cooking
Gardening
Car Washing
Others
Spoken English
Spoken Chinese
Spoken Mandarin
Declaration
*
I declare that the information given in this application form is true and complete. I understand that if I have given anymisleading information on this form or made any omissions, this will be sufficient grounds for terminating my employment.
Consent
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I agree that South China International Human Resource Co. may disclose my biodata to potential employers to seek
Contact Number (Please download Whatsapp)
*
Please make sure the provided phone number is correct and reachable by both call and WhatsApp. If the number is incorrect, we won't be able to contact you for the interview.
Important Reminder for Application Submission
Please be reminded that applications will not be considered if they do not include a picture, WhatsApp contact information, or complete details of working experience. Thank you for ensuring that all required information is provided!
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Health Declaration
FAMILY HISTORY
*
Yes
No
If
YES
, please state below
for ALL family members with health status in detail.
Have any of your parents or family ever had cardiovascular diseases, kidney disease, diabetes,stroke, cancer, hereditary diseases or mental disorder?
DOMESTIC HELPER HEALTH DECLARATION
*
Yes
No
If yes, please state in detail (e.g. average daily / weekly consumption and type
Have you smoked any cigarettes, e-cigarettes including vaping, cigar, pipe or chewing tobacco within the past 12 months?
Do you consume alcohol regularly?
Do you participate in, or do you intend to participate in any private flying, any hazardous sports, or races?
Please tick the appropriate box
*
Yes
No
If yes, please state in detail (e.g. Type of illness, treatment & condition & current condition)
Asthma, emphysema, tuberculosis or other lung diseases?
Diseases of heart and blood vessels such as high blood pressure, chest
pain?
Hepatitis or hepatitis carrier, ulcer or bowel, liver or gall bladder
disease?
Renal stone or any disorder of the genitourinary disorders?
Epilepsy, stroke, mental or nervous disorders?
Diabetes, venereal disease, cancer, tumour, or any blood diseases?
Severe injury, gout, back pain, or other musculoskeletal disorders?
In the past 5 years, have you: (Please tick the appropriate box)
*
Yes
No
had, or been advised to have blood tests, electrocardiograms or X-rays? (e.g. Cholesterol, AIDS or Hepatitis etc.)
had any illness requiring regular medical treatment or advice, operation
or hospitalization not mentioned above?
Are you now receiving or contemplating any operation or medical treatment?
DECLARATION & AGREEMENT & PERSONAL DATA
All information and statements provided in the application, whether self-completed or otherwise, are complete, accurate, and truthful. In accordance with the provisions of the Personal Data (Privacy) Ordinance of Hong Kong, by signing below, I consent and authorize the company to possess, collect, store, and use my personal data for the purpose of record keeping or disclose to my employer.
Signature
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