Bio Data Form

Employment Application

Full Name*

First NameLast Name

Age*

Date of Birth

Date

Place of Birth

Religion

Gender

Civil Status

Number of Children

Age of Children

Height

Weight

Mobile Number*

Country CodePhone Number

Current Address*

Street Address

Street Address Line 2

DistrictRegion

CountryCountry

Philippine Address

Street Address

Street Address Line 2

CityProvince

Tel Philippines

Employment Status*

EDUCATION

Highest level of education completed:*

WORK HISTORY

Please list your four most recent employers, list the most recent first

1. Employer

Employer's Name (Most current)

Location

City & Country. For Hong Kong please enter District

May we contact this employer?

YESNO

Phone number

Country CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Duties:

Reason for leaving

2. Employer

Employer's Name (Second most recent)

Location

May we contact this employer?

YESNO

Phone number

Country CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Duties:

Reason for leaving

3. Employer

Employer's Name (Third most recent)

Location

May we contact this employer?

YESNO

Phone number

Country CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Duties:

Reason for leaving

4. Employer

Employer's Name (Fourth most recent)

Location

May we contact this employer?

YESNO

Phone number

Country CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Duties:

Reason for leaving

ADDITIONAL INFORMATION

Willing to take care of new born babies*

YesNo

Willing to take care of children*

YesNo

Willing to take care of elderly*

YesNo

Willing to take care of male disabled person/bedridden elderly**

YesNo

Willing to take care of female disabled person/bedridden elderly**

YesNo

Willing to take care of pets*

YesNo

Willing to work together with another helper*

YesNo

Willing to change day off*

YesNo

Known medical conditions (please specify below)*

YesNo

*Including bathing and help going to toilet/changing diapers

List any additional information you would like us to consider:

Skills / Medical conditions / Allergies / Preferences

SELF EVALUATION

Capabilities*

	Excellent	Good	Fair	Poor
Care of New Born
Care of Child
Care of Elderly
Care of Disabled
Care of Bedridden
Care of Pet
Cooking (Chinese)
Cooking (Western)
Household Chores
Car Washing
Child Tutoring
Cantonese Proficiency
Mandarin Proficiency

Preferences*

	Very Interested	Somewhat Interested	Not Interested
Care of Baby
Care of Child
Care of Elderly
Care of Bedridden
Care of Pet
Cooking
Household Chores

REFERENCES

If you have any previous employers who we are allowed to contact, please enter their name and contact number here:

1. Full Name

First NameLast Name

Best phone number to reach them

Country CodePhone Number

2. Full Name

First NameLast Name

Best phone number to reach them

Country CodePhone Number

AUTHORIZATION

I understand that Fair Choice is making no employment offer at this time. I certify that the information in this application is correct to the best of my knowledge. I understand that any misrepresentation or omission of any fact in my application, resume, or any other materials, or during interviews is grounds for disqualification from further consideration for employment or for termination, if employed.

I authorize Fair Choice to contact any company or individual it deems appropriate to investigate my employment history, character, qualifications and other relevant information, if job-related.

I agree that Fair Choice may disclose my personal profile to potential employers and online for the purpose of seeking employment as domestic helper / driver for me.

Pre-employment medical check-up may be required.Testing may be applicant or employer paid based on the employer.I understand that any offer of employment may be withdrawn if a condition is discovered for which no reasonable accommodation can be made.

I understand that this application is current for 60 days. At the conclusion of this time, if I have not heard from Fair Choice and still wish to be considered for employment, it may be necessary to complete a new application.

I understand that if hired, employment is at-will, and may be terminated by the employer at any time, with or without cause or notice, for any reason or no reason.

By entering your name, you agree to accept the terms of the above document with an electronic signature.*

I agreeI do not agree

You must agree to accept the terms of the document in order to submit an application.

Type signature*

Date*

YYYY-MM-DD

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