| *E-MAIL |
|
| *First Name |
|
| Middle
Name |
|
| *Last Name |
|
*Home Address
(PO Box Not
Accepted) |
|
| *Country |
|
| *Present Employer Address |
|
| *Telephone # (include area
code) |
|
| Fax #
(include area code) |
|
| Mobile
# (include area code) |
|
| *Indicate if this position is
for |
Children
Elderly
Disabled |
| *Highest Educational
Attainment |
|
| *Diploma/Degree Obtained? |
|
| *Additional Education and
Training |
|
| *Date of Birth |
|
| *Place of Birth |
|
| *Nationality |
|
| *What languages do you
speak? |
|
| *Religion |
|
| |
| *Your Marital Status |
|
| *How is your general
health? |
|
| *Passport Number |
|
| *Expiry Date |
|
| *Working VISA expiry date |
|
| |
| *Can you swim? |
|
| |
| *Do you drive? |
|
| Hobbies |
|
| |
| *Will you work with
Dogs/Cats? |
|
| *Can you cook? |
|
| *What types of food? |
|
| |
EMPLOYMENT
HISTORY:
Please begin with your present
employer |
| *Employer Name: |
|
| *Position |
|
| *Date of Employment |
|
| Finish
Date (Leave blank if not sure) |
|
| *Ages of persons under
care |
|
| *Country |
|
| *Duties/Responsibilities |
|
| *Reason For Leaving |
|
|
| Employer Name: |
|
| Position |
|
| Date
of Employment |
|
| Finish
Date |
|
| Ages
of persons under care |
|
| Country |
|
| Duties/Responsibilities |
|
| Reason
For Leaving |
|
|
| Feel free to
email us any previous related employment
information. |
CHILDCARE
EXPERIENCE
*What ages
of children have you cared for in the
past? |
0-8 months
9-18 months
18 months to 2
years
2-4
Years
4-6 Years
6-10 Years
10-12 Years
12 & up |
| *What capacity of care did you
provide? |
|
| *Have you taken a first aid
course? |
|
| *Have you taken a caregiver
course? |
|
| *Are you willing to work for a
single parent? |
|
| |
| *Do you have Eldercare
experience? |
|
| |
| *Will you take full charge of
children in your employers absence? |
|
| *What activities did you do
with the children? Please specify |
|
| *What outdoor sports did you do
with the children? Please specify |
|
| |
| Please rate your
level of skill for each of the following
duties. |
| *Please explain why you make a
good caregiver |
|
| *Please take this opportunity
to write a letter from you to a perspective
employer. Explain what you are all about,
provide as much detail as you can. |
|
|
|
