Personal ID information

Your Current location	Select your location Argentina Australia Austria Bahamas Bahrain Barbados Belgium Bosnia and Herzegovina Canada China Cyprus Czech Republic Denmark Finland France Germany Greece Hungary Hong Kong Hungary Iceland Ireland Italy Israel Jamaica Japan Jordan Luxembourg Mexico Netherlands New Zealand Norway Poland Portugal Philippines Russia Saint Lucia Saint Vincent and The Grenadines Saudi Arabia Singapore Slovakia Slovenia Spain Sweden Switzerland Trinidad and Tobago Taiwan Tunisia United Arab Emirates Ukraine United Kingdom United States
First Name.
Last Name
Initial /Middle Name:
Sex	Male Female
Age
Date of Birth
Marital Status
Nationality
Religion
Any Children
"if yes" ages
Your Height
Your weight
Passport #
Passport expiry date
Birth place

Educational Information

College/University...?
How many years...?
Degree/Diploma...?	e.g  BS in
Undergraduate...?
Other Training...?
Other Training...?

CHECK-SPOKEN LANGUAGES:

English        French         Spanish         Russia      Greek   Polish  
Cantonese   Italian          German          Finnish    Hindi     Japanese     
Mandarin     Swedish      Portuguese   Tagalog   Punjabi      
Arabic          Ukrainian     Hebrew       
Other       

How would you rate your English language skill ... ?

bad poor average fair good

How would you rate your French language skill... ?

bad poor average fair good

How would you rate your Cantonese language skill... ?

bad poor average fair good

How would you rate your Mandarin language skill... ?

bad poor average fair good

How many year in total of nanny/housekeeper Experience?

Enter # of Kids you're willing to care for at a time

Check Questioner IF YES OR ABLE

Are you able to care for all age group?
Can you work for a single parent?
can you work flexible schedule?
Will you work overtime if paid extra?
Can you sign a minimum of 2 yrs contract?
Do you have CPR/First Aid Training?

If you do not have CPR/First Aid, are you willing to take a one day training..

Can you travel with employer if needed?
Do you have driver's license?
If no, are you willing to learn & become driver?
Can you swim?
Do you smoke?
Do you drink alcohol?
Do you suffer from allergy?
Have you ever suffer from any infectious disease?
Do you suffer from any physical defects?
Undergone any surgery over the last 24 months?
Have you committed any criminal offence?
Been accused of THEFT employers or others?
Do you attend church weekly?

How many times a week do you go to church ... ?

Do you enjoy play with children?
Can you tutor children?
Can you walk Kids to school if needed?
Can you toilet train if needed?
Can you/willing to change baby diapers?
Can you care for sick kid if parent not home?
Can you take kids to after school activities?
Are you willing to work anywhere in Canada?

If you are not willing to work anywhere in Canada, location your prefer?

Do you have friends in Canada?

Do you like (cats/dogs) pet?

Name pets you are most afraid and will not like to work in the house with?

(Beware most Canadian family has dogs or cats)

Can you care for kids, if employer go on a trip?

Earliest date you will be available to work in Canada?

How would you rate your cooking skill... ?

1 2 3 4 5

if you're not good at cooking, who does the cooking?

What type of cooking do you do best ... ?

How would you rate your organizational skill ... ?

1 2 3 4 5

How would you rate your housekeeping skill ... ?

1 2 3 4 5

DETAILED WORKING EXPERIENCES-FIRST EMPLOYMENT:

Will not contact employer without your consent

Location & Position?
From when -Till?
# of Persons in your care?
List their ages?
Reason for leaving?
Employer's name?
Employer's name?

SECOND EMPLOYMENT:

Location & Position?
From when -Till?
# of Persons in your care?
List their ages?
Reason for leaving?
Employer 's contact #?
Employer's name?

THIRD EMPLOYMENT:

Location & Position?
From when -Till?
# of Persons in your care?
List their ages?
Reason for leaving?
Employer 's contact #?
Employer's name?

CURRENT EMPLOYMENT:

Location & Position?
From when -Till?
# of Persons in your care?
List their ages?
Reason for leaving?
Employer 's contact #?
Employer's name?

Can we contact your previous employer for verbal reference?

Contact employer for reference "If no"why?

Caregiver Contact/Mailing information

First Name
Last Name
Street Address
City
Country
Work Phone
Home Phone
Cell Phone
FAX
E-mail
Re-enter E-mail
Optional Email
Note: if your email if wrong, you will not hear from us so, make sure your email is completely enter.

PLEASE PROVIDE INFORMATION OF YOUR EXTENDED FAMILY:

First Name
Last Name
How is this person related to you?
Street Address
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
Optional Phone

CAREGIVER FAMILY/FRIENDS IN CANADA INFORMATION

Full Name
Full Address
profession
Home Phone
Cell/ work
	Second Family/Friend in Canada
Full Name
Full Address
profession
Home Phone
Cell/ work
	Third Family/Friend in Canada
Full Name
Full Address
profession
Home Phone
Cell/ work

Do you have written references from previous employer(s)... ?

Do you have references

What are your hobbies?

 

How did you hear about NFDA Canada

          Select one Ad in News Paper Internet (Alta Vista) Internet (Yahoo) Super Pages Google Ad On Tv Internet Other Link Previous Employer Through Friends in Canada Through Friends at my current location Our Sub Agent(s) Previous Client Other

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