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| Application Information Sheet 申請人資料 | |||||
| Name姓名 | DWI LASMIATI | Age年齡 | 28 years old / 牛 / 魔羯座 | ||
| Nationality國籍 | Indonesian | Date of Birth出生日期 | 1998 | ||
| Gender性別 | F | Marital Status婚姻狀況 | Married | ||
| Education學歷 | Junior High School 初中 | Height身高 | 153 cm | ||
| Religion宗教 | Muslim 回教 | Weight體重 | 60 kg | ||
| In the Family No.在家排行 | Son / Age兒子數目/年齡 | 1 / 4Yrs歲 | |||
| Brother / Sister兄弟姊妹 | 2 / | Daughter / Age女兒數目/年齡 | 1 / 4Yrs歲 | ||
| Address地址 | |||||
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| Previous Employment Record 工作紀錄 1 | |||||
| Country 工作地點 | SURABAYA, INDONESIA | Salary 薪金 | BASIC | ||
| Duration 工作期間 | 2018 - 2021 | Total people to served 總服務人數 | 2 PERSON 1 BABY | ||
| Terminationreason 離開原因 | FINISHED | ||||
| Care of Baby | 照顧嬰身 | NB | 個月 | Care of Toddler | 照顧幼兒(1-3) | Yrs歲 | |||
| Care of Child | 照顧小孩(4-12) | Yrs歲 | Care of Elderly | 照顧老人 | Yrs歲 | ||||
| Care of Disabled | 照顧殘疾人士 | Yrs歲 | Care of Bedridden | 照顧卧床人士 | |||||
| Care of Pets | 照顧寵物 | Household Works | 家務 | ||||||
| Car Washing | 洗車 | Gardening | 打理花園 | ||||||
| Cooking | 烹飪 | Driving | 駕駛 | ||||||
| Previous Employment Record 工作紀錄 2 | |||||
| Country 工作地點 | BALI, INDONESIA | Salary 薪金 | BASIC | ||
| Duration 工作期間 | 2024 - 2026 | Total people to served 總服務人數 | 1 PERSON 1 CHILDREN | ||
| Terminationreason 離開原因 | FINISHED | ||||
| Care of Baby | 照顧嬰身 | 個月 | Care of Toddler | 照顧幼兒(1-3) | BOYS 3 YEARS | Yrs歲 | |||
| Care of Child | 照顧小孩(4-12) | Yrs歲 | Care of Elderly | 照顧老人 | Yrs歲 | ||||
| Care of Disabled | 照顧殘疾人士 | Yrs歲 | Care of Bedridden | 照顧卧床人士 | |||||
| Care of Pets | 照顧寵物 | Household Works | 家務 | ||||||
| Car Washing | 洗車 | Gardening | 打理花園 | ||||||
| Cooking | 烹飪 | Driving | 駕駛 | ||||||
| Educational Background 學歷背景 | |||
| Level 程度 | Name of school 學校名稱 | Period 就讀期間 | Qualification attainment 獲取名銜 |
| High School 高中 | - | ||
| College/University 大學 | - | ||
| Courses Studies 其他課程 | - | ||
| Special Training 其他學歷 | - | ||
| Supplementary Questions 附加問題 | Yes 是 | No 否 | ||
| 1. | Do you eat pork? 你會否食豬肉? |
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| 2. | Accept Day-off not on Sunday? 接受假日不在星期日? |
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| 3. | Sharing a room with babies / children / elder? 你願意和小孩/嬰兒/長者同房嗎? |
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| 4. | Are you afraid of dog or cat? 你會害怕狗或貓? |
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| 5. | Do you smoke? 你會抽煙嗎? |
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| 6. | Do you drink alcohol? 你會喝酒嗎? |
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| 7. | Have you any prolonged illnesses / undergone surgery? If Yes: 你有任何長期的疾病/做過手術嗎? |
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| 8. | Are you willing to share job with another worker? 你是願意與其他工人一起工作? |
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Declaration by Applicant
| / Saya MenyatakanBahwa : Saya PribadiMemberikanInformasi Saya Kepada FOREVER SUNSHINE EMPLOYMENT AGENCY LTD. Informasi Yang Diberikan Di Sini FormulirIni (halaman 1,2) AdalahBenar Dan TepatUntuk Yang Terbaik Dari Pengetahuan dan Keyakinansaya. Saya Akan BertanggungJawabPenuhJikaInformasiTerbuktiPalsu. I certify that : I personally supplied my information to FOREVER SUNSHINE EMPLOYMENT AGENCY. The information furnished herein this form (page 1,2) is true and correct to the best of my knowledge and belief. I will take full responsibility if any information proves to be false. 本人茲證明: 本人親自向永晴僱傭有限公司提供我的資料。在盡我所知及所信下, 此表(頁1,2) 上的資料是真實及正確的。如被證實有虛假資料，我將承擔全部責任。 |
| Signature of Applicant: | Date: |
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