// The Great World International Management, Inc. Philippines \\

Position Applied for:
Name:
Permanent Address:
Age:
Sex:
Height:	cm.
Weight:	kgs.
Compexion:
Date of Birth:
Place of Birth:
Civil Status:
Nationality:
Religion:
Blood Type:
Telephone Number:
Do you smoke?	Yes No
Do you have a Driver's License?	Yes No
Family Status:
Name of Spouse:
Occupation:
No. of Children:
Ages of Children:
Who will take care of your children when you work overseas?
Name of Father:
Date of Birth:
Name of Mother:
Date of Birth:
EDUCATIONAL BACKGROUND
Elementary School Attended:
Year Attended:
High School Attended:
Year Attended:
College Attended:
Year Attended:
Vocational School Attended:
Year Attended:
Course Completed:
Special Skills:
Language and dialect you can speak:
EMPLOYMENT RECORD (from the most recent work backwards)
Date of Employment and Position
Name of Employer
Address

Date of Employment and Position
Name of Employer
Address

Date of Employment and Position
Name of Employer
Address

Date of Employment and Position
Name of Employer
Address

Date of Employment and Position
Name of Employer
Address

Please check the appropriate boxes of the care giving chores that you can perform: (check all that apply)
CHILDCARE	Bathing Feeding Changing Diapers Sterilized Utensils Play Therapy Mat Exercises Others

AGED AND DISABLED PERSON	Toilet Assistance Giving Bath Feeding Changing Diapers Dressing Taking Temperature Giving Medicine Wound Care Bed Mobility Technique Biochemical Education Therapeutic Massage Transfer Technique Galt Training Joint Mobilization Hydrotherapy Balance Training Postural Education Soft Tissue Sterilization Others

TAKING UP VITAL SIGNS	Blood Pressure Respiratory Rate Body Temperature Pulse Rate

APPLIANCE OPERATION	Washing Machine Microwave Oven Stove/Oven Rice Cooker Vacuum Cleaner Blender Electric Dish Washer & Drier Others
DECLARATION
I hereby declare that I am applying for work in as . I further declare that the above information are true to the best of my knowledge. I give my solemn promise to finish my year(s) contract and will uphold the reputation of the country in which I now desire to be employed.
Passort No.	Date of Issue:
Place of Issue:	Date of Expiration:
Print Name and Signature: (typing your name serves as your signature)
Important Note: Please submit your photo with your name to photos@greatworld.com

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