Gender

Male Female

Name

Contact number

District

Referral Name and contact numbmer

Preferred Nationality of Domestic Helper

Indonesian Filipino Bangladesh Sri Lanka Cambodia

Number of adult

Number of children

0 1 2 3 4 5 6 7 8 9 10

Number of elderly

0 1 2 3 4 5 6 7 8 9 10

House size (sq. ft.)

Do domestic helpers have own room

Yes No, share the room with the elderly No, share room with children

Holiday arrangement

Saturday Sunday

Special requirements for domestic helper

Send