Yes | No | Yes | No | ||||
i. | Mentall illness | vi. | Tuberculosis | ||||
ii. | Epilepsy | vii. | Heart disease | ||||
iii. | Asthma | viii. | Malaria | ||||
iv. | Diabetes | ix. | Operation | ||||
v. | Hypertension | x. | Other |
18. Physical disability:
19. Dietary restrictions:
20. Food handling preferences: No Pork No Beef OTHERS:
A3 Other21. Preference for rest day:
22. Any other remarks: CAREGIVER FOR 6 MONTHS IN SG
(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)
Yes/No |
Yes/No If yes, state the no. of years |
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. |
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Yes/No If yes, state the no. of years |
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. |
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(C) EMPLOYMENT HISTORY OF FDW
C1 Employment History Overseas
Date | Country (including FDW's home country) |
Employment | Work Duties | Remarks | |
From | To | ||||
03-Mar-2019 | 09-Sep-2019 | SINGAPORE | DAWN TAN | CAREGIVER | |
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 |
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