JACK FOCUS EMPLOYMENT PTE LTD

ROC NO: 200517524K
Licence : 06C5025

Ref No: BSB6150

 


BIODATA OF FOREIGN DOMESTIC WORKER (FDW)
*Please ensure that you run through the information within the biodata as it is an important document to help you select a suitable FDW

(A) PROFILE OF FDW A1 Personal Information
  1. Name: SUCIHATI BT KASTURI REJO
  2. Date of Birth: 17-Jan-1978
  3. Age: 40
  4. Years of Experience: 0
  5. Place of Birthday: KENDAL
  6. Height & Weight: 153 cm 58 kg
  7. Nationality: INDONESIA
  8. Residential address in home Country: DS. PODOSARI RT. 002 RW. 001 KEC. CEPIRING KAB. KENDAL
  9. Name of Port / Airport to be repatriated to: AHMAD YANI SEMARANG
  10. Contract number in home Country: 
  11. Religion: MOSLEM
  12. Education level: JUNIOR HIGH SCHOLL
  13. Number of Siblings: 3
  14. Marital Status: Married
  15. Number of children: 1
  16.      -Age(s) of children(if any): 14
A2 Medical History/Dietary/Restrictions
16. Allergies (if any): 
17. Past and existing illness (including chronic ailments and illnesses requiring medication)

18. Physical disability: 

19. Dietary restrictions: 

20. Food handling preferences:  No Pork     No Beef     OTHERS: 

A3 Other

21. Preference for rest day: 

22. Any other remarks: 

(B) SKILLS OF FDW

 B1 Method of Evalution of Skills

Please indicate the method(s) used to evaluate the FDW's skills (can tick more than one)

 Based on FDW' declaration, no evaluation/observation by Singapore EA or overseas training centre/EA
 Interviews by Singapore EA
 Interviewed via telephone/teleconference
 Interviewed via videoconference
 Interviewed in person
 Interviewed in person and also made observation of FDW in the areas of work listed in table

S/No
Areas of Work
Willingness
Yes/No
Experience
Yes/No
If yes, state the no. of years
Assessment/Observation
Please state qualitative observations of FDW and/or rate the
FDW (indicate N.A. of no evaluations was done)
Poor.....Excellent...N.A.
1 2 3 4 5 N.A.
1.
Care of infants/childrenPlease specify age range:
No. of years:
2.
Care of elderly
No. of years:
3.
Care of disabled
No. of years:
4.
General housework
No. of years:
5.
CookingPlease specify cuisines:
No. of years:
6.
Language abilities (spoken)Please specify
-
No. of years:
7.
Other skills, if any Please specify
-
No. of years:
Interviewed by overseas training centre/EA (Please state name of foreign training centre/EA): 
State if the third party is certified (e.g. ISO9001) or audited periodically by the EA: 
 Interviewed via telephone/teleconference
 Interviewed via videoconference
 Interviewed in person
 Interviewed in person and also made observation of FDW in the areas of work listed in table

S/No
Areas of Work
Willingness
Yes/No
Experience
Yes/No
If yes, state the no. of years
Assessment/Observation
Please state qualitative observations of FDW and/or rate the
FDW (indicate N.A. of no evaluations was done)
Poor.....Excellent...N.A.
1 2 3 4 5 N.A.
1.
Care of infants/children Please specify age range:
No. of years:
2.
Care of elderly
No. of years:
3.
Care of disabled
No. of years:
4.
General housework
No. of years:
5.
CookingPlease specify cuisines:
No. of years:
6..
Language abilities (spoken)Please specify
-
No. of years:
7..
Other skills, if any Please specify
-
No. of years:

(C) EMPLOYMENT HISTORY OF FDW

C1 Employment History Overseas

Date Country
(including FDW's home country)
Employment Work Duties Remarks
From To
15-May-2001 19-May-2003 HONG KONG MR. CHING HAU LING TAKE CARE OF CHILDREN 10YO, COOKING AND GENERAL HOUSEWORK 2 YEARS
18-Jun-2008 18-Jun-2013 MIDDLE EAST MR. IBRAHIM TAKE CARE OF CHILDREN 8 YEARS OLD, TAKE CARE OF ELDERLY 63 YEARS OLD,COOKING NAD GENERAL HOUSEWORK 5 YEARS

C2 Employment History in Singapore

Previous working experience in Singapore Yes No

(The EA is required to obtain the FDW's employment history from MOM and furnish the employer with the employment history of the FDW. The employer may also verify the FDW's employment history in Singapore through WPOL using SingPass)

C3 Feedback from previous employers in Singapore

Feedback was/was not obtained by the EA from the previous employer. If feedback was obtained (attach testimonial if possible), please indicate the feedback in the table below:

Feedback
Employer 1
Employer 2

(D) AVAILABILITY OF FDW TO BE INTERVIEWED BY PROSPECTIVE EMPLOYER
  FDW is not available for interview
  FDW can be interviewed by phone
  FDW can be interviewed by video-conference
  FDW can be interviewed in person



FDW Name and Signature

Date:

EA Personnel Name and Registration Number

Date:



I have gone through the biodata of this FDW and confirm that I would like to employ her



Employer Name and NRIC No.

Date:


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IMPORTANT NOTES FOR EMPLOYERS WHEN USING THE SERVICES OF AN EA