1) This document appears to be an application for a domestic helper position. It collects basic personal information such as name, address, age, marital status, education history, language skills, and references. 2) The second part includes questions to assess the applicant's suitability for tasks like baby care, elder care, housekeeping, cooking, and willingness to work certain hours and conditions. 3) The applicant provides details of any relevant experience they have in baby care, elder care, housekeeping, and cooking.

1. {,,, } EabylChild Care t l Gefi+r*l HousekeePing
Ref- N*,
t,l Caoking { ] Care Otd Aged/B*dridden
tAl
Name: Nationality:
Home Address : Tel :
Fiace of Blrth : Oate of Eirh; Age :
:--
Religion -.-Ht :Wt :-
$Latus: -'- Date of lrtarriage:-----
Hame nf Spsuse:
Oetrupatian Aga:
Ho. af Chitdren : [l]noo :
1 st Ghild Date of Birlh :
Father's Occ : Ags:
fJother s Occ I Age:
i,Jo. of Erothers, fllRs*,
Sisters: egu
No. of lf :
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SPOHEFI EI'JGLISH
FOOE{ }LITTLE{ ) FAIF { i G00F {
WRITTEI,I EJ'IGLISH
I
PooR( )LTTTLE{ ) FAIR i i GOOF {
OTHER LANGUAGES
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DARK { TANi'IED { FAIF {
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2. Narne Of Schaol Year Graduated
Efementary:
High Schoet:
';".."l,.,-
'i :1 ! '"t-' 1 " |,'f,i',,l)
Coti;rge: .i':l'.'.-i-q:' ,,.i1,]'.'t5:1r.""'
Other Trainin5l : ,
Name of Employer Mstd's Postlion No of Years
j.- i'a i r-- r .-:- Fi'; ,l i]r- ; ;''-'. fr.i :.'1:._i
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1) Wll you wsrk$here ?......,......-..
there afo pcb fYestkl
2) Da you have sny fillergtes ?.....,......."... (t{r/l{o}
3J Dc you have sny kntrwtadge In gardenirtg ?..........
4i Can you toudr pork ?...-.-... .,,...... [Yes&l*]
5) Can you eet pork ? fYes4{r}
6! Can you do sirnpla sewing ? ,....,.......... {YesJ}b}
7J ?-----...."...-...
Oo you smoke ...--.. {fffi/No}
8] Can you dnve ?.........-.,..... -.------- fiffi/No)
9j Genyouwash ar? .......-.. ......... tYes/tbl
101 Are you willing to r,ror* 3 hausac with compensatiEn ? ....-.... f$e/f'lo)
11) C€n you beke ?--..-....,....... .....;..-........." ..---.... (Yes/H1
12] Areyouwilllngtotakecemof neulyborn?..,....,.,...... .."... {k/Ho)
13) hre yau willing to carE lnvald Fercan ?........."....." fYes/fbl
14) Are you cfroosy aboutfood ?.....-........,. ,....,.. {&rNo}
15) Are you a vegatarlan............. .-... ffiA|o)
16i Wfro udtltske carB of yourdtlldrun Flul u,utsnsfsii

3. What experience do you have in bsby-cafe and ejrtH+are ?
(Cive the age-s lhal you have laken csre of. give details ifi your offt horna or woftlng with othcrs-)
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Whsl cxFerience do you heve fn taking care of lhe eged of bedrlddcn ? iGlva detgtts)
il-l,iq-r.,,"fi-rt. t-:i,r1r',r+ tji,f.Ir, -i.1 -l-
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What experiefice do lru h*ve {n Genarsl houserrurk ? (Gfue detalls)
:*i-', tl, r:..i .,riL.. .--:f rt;t i.;l ii,r,,r.
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lrthal experience do you have in coohlr€ ? (Give detailsl
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Afpllc€ntE siqflature ; i I irlrl