Due to a high volume of applications for caregivers coming from the Philippines or India, the processing time at the Canadian consulate office is between 18 to 24 months. (India - 16months)  As a result of this significant increase in processing time, we are unable to process any more applicants in both countries.
For those that can process in less than 3months: Please state the country that you are writing from. E-mail our Overseas Placement Coordinator for program info. 
PERSONAL INFORMATION
Surname **

  Date of Birth** Year
Given Name **   Month Day
Middle Name Age**
Marital Status** Gender**
Contact Number**
Email Address:
Country you are located now:

Number of Brothers

Place of birth
Number of Sisters Weight (kg)
Nationality Height (cm)

Religion Where are you in the birth order?
Do you smoke? yes no Do you drink alcohol? yes no
Name of Spouse Spouse Occupation
No. of children Spouse's Age
Drive a car yes no  
How long have you been driving? / years Have you had any accident? yes no
Driving Licence Number
Do you have any criminal record? yes no
Can you communicate in English? yes no What Chinese
languages can you speak? **
Other Languages  
What did you study at college / university ** Undergraduate Graduate
Major Subject in College Special Courses Taken

OVERSEAS EXPERIENCE
Have you worked in any foreign country before? yes no If yes, state with counties
How long have you worked in all counties / years
    

WORK EXPERIENCE (Give Full Details)
PRESENT EMPLOYER
Name of Employer Phone No.
**Date Contract Begins Year Month Day
**Date Contract Finishes Year Month Day
Availability** Country
Employer Address
Describe your duties
Reason(s) for leaving

FIRST PREVIOUS EMPLOYER
Name of Employer Phone No.
Date Contract Begins Year Month Day
Date Contract Finishes Year Month Day
Employer Address
Country
Describe your duties
Reason(s) for leaving

SECOND PREVIOUS EMPLOYER
Name of Employer Phone No.
Date Contract Begins Year Month Day
Date Contract Finishes Year Month Day
Employer Address
Country
Describe your duties
Reason(s) for leaving
 

GENERAL INFORMATION ** (please select based on your EXPERIENCE and PREFERENCES)

Have you undergone any operation ?
Can you swim?
Will you work where there are pets?
Are you willing to work with no day off ?
Days willing to work per week
How many children can you care for?
Are you willing to take care of old people or bedridden ?
Are you willing to take care of dis-able person ?
Are you willing to take care of new born baby?
Are you willing to work for single parent ?
Are you willing to work in a small / rural town?
Are you willing to take care of children ?
Are you willing to take charge of the household in the employer’s absence?
Do you Know First Aid?

FOR INFANT AND CHILDCARE
If you have cared for infant or children, do you have any experience in the following:

Bathing: Sterilised Utensils: Changing Diapers:
Feeding: Play Avtivities & Games:    
What types of food do you prepare for the children?
What types of activities do you do with the children?

FOR ELDERLY & DISABLED AND BEDRIDDEN
If you have cared for elderly, do you have any experience in the following.

Bathing : Take a Walk: Prepare Food :
Dressing: Changing Diapers: Feed Medicine:
Massage : Feeding: Test Blood Pressure:

HOUSEKEEPING EXPERIENCE**
Indicate below your specific housekeeping skills.

Clean House: Washing Clothes: Gardening:
Ironing: Vacuuming: Sewing:

 

COOKING EXPERIENCE**
Indicate below your specific cooking skills.

Western food:

Filipino Food: Baking Cookies :
Italian food: Spaghetti : Baking cakes:
Chinese food: Making sandwiches: Can you plan the menu ?

Who should be contacted in case of Emergency?

In your home town ( Relative / Friend in the Philippines )
Name: ** Relationship to you: **
Tel No. ** Alternate Telephone Number:
Address: **




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