JACK FOCUS EMPLOYMENT PTE LTD

ROC NO: 200517524K
Licence : 06C5025

Ref No: BS1941

 LOCAL EXPERIENCE 4 YEAR IN JAKARTA BS 1941


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: SUKINAH
  2. Date of Birth: 20-Apr-1995
  3. Age: 23
  4. Years of Experience: 0
  5. Place of Birthday: CILACAP
  6. Height & Weight: 150 cm 44 kg
  7. Nationality: INDONESIA
  8. Residential address in home Country: 
  9. Name of Port / Airport to be repatriated to: 
  10. Contract number in home Country: 
  11. Religion: MOSLEM
  12. Education level: JUNIOR HIGH SCHOOL
  13. Number of Siblings: 0
  14. Marital Status: Married
  15. Number of children: 1
  16.      -Age(s) of children(if any): 10 MONTHS
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: LOCAL EXPERIENCE 4 YEAR IN JAKARTA BS 1941

(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
05-Mar-2013 15-Dec-2017 KRISTIN SUTANDI TAKE CARE THE CHILDREN 2 AND 4 YEARS OLAD AND DO GENERAL HOUSE KEEPING AND OTHER.

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:


***************

IMPORTANT NOTES FOR EMPLOYERS WHEN USING THE SERVICES OF AN EA