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Personal Details
First Name
Middle Name
Last Name
Date of Birth
Place of Birth
Gender
Male
Female
Others
Height (cm)
Weight (kg)
Religion
Marital Status
Single
Married
Divorced
Widowed
I have a partner, but we are not legally married
Education Level
Primary School Graduate
High School Graduate
Undergraduate (I attended college but did not graduate)
College Graduate (I have a college degree)
Passport Status
Valid Passport
Passport Expired
No Passport Yet
If you have a valid passport, when does your passport expire? (MM/DD/YYYY)
Vaccination Status
Fully Vaccinated (2nd dose + Booster)
Partly Vaccinated (Only up to 1st dose or 2nd dose)
Not Vaccinated
Full Address of your permanent home in the Philippines
City
Zip Code
Province
Country
Mobile No.
Email
Facebook Messenger Name
Do you have the WhatsApp messenger app?
Yes
No
What is your WhatsApp number?
Please provide an emergency contact number and your relationship to your emergency contact
Working Abilities
Have you worked as a Domestic Helper before?
Yes
No
If yes, how many years have you worked as a Domestic Helper?
If you have worked abroad as a domestic helper before, have you completed at least one full contract?
What is your current job?
Select the option that best answers the question.
A. I am confident, and I can do this independent
B. I have some knowledge, but I need more guidance
C. I have no experience, and I need training
D. I am unable to, or don't want to do this
(Please tick in the relevant columns below)
How confident do you feel about speaking English?
A
B
C
D
How skilled are you at house cleaning?
A
B
C
D
How skilled are you at cooking?
A
B
C
D
How skilled are you at caring for infants (0 – 12 months)?
A
B
C
D
How skilled are you at caring for toddlers (1 – 5 years old)?
A
B
C
D
How skilled are you at caring for children (6 – 12 years old)?
A
B
C
D
How skilled are you at caring for teens (13 years old & above)?
A
B
C
D
How skilled are you at caring for elderly (healthy but need assistance)?
A
B
C
D
How skilled are you at caring for Special Needs Individual?
A
B
C
D
How skilled are you at caring for bedridden patients?
A
B
C
D
How skilled are you at caring for pets?
A
B
C
D
How skilled are you at washing cars?
A
B
C
D
How skilled are you at gardening?
A
B
C
D
How did you hear about Nepturia Employment Agency?
Facebook
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Friend / Family recommendation
Media / Article
Others (Please specify)
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