Job Request English Employer's Name (Husband)(Required)Employer's Name (Wife)(Required)Full Residential Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number(Required)Email(Required)Employer's Occupation(Required)Does the employer frequently work from home (WFH)?(Required) Yes No Is there anyone else authorised to manage the household worker?(Required) Yes No Name and Relationship to the Employer(Required)Family Status(Required) Married Single Parent Divorced Other Emergency Contact(Required)Name: Telephone Number: Name: Telephone Number: Name: Telephone Number:Type of Residence(Required) House Apartment Townhouse Other Property Size(Required)in square metres (m²)Number of Floors(Required)Is there a lift available?(Required) Ya Tidak Total Number of Permanent Residents(Required)Please list everyone living in the property(Required)Husband Wife Children: … Elderly person(s): … Other household member(s): …Pets at the Property(Required) None Dog Cat Bird Hamster Reptile Other Other Pet Details(Required)Where are the pets kept?(Required) Inside the property Outside the property In a designated area Is the worker expected to assist with pet care?(Required) Ya Tidak General Household Environment(Required) Calm (normal household activities) Active / frequent family activities Frequently receives guests Property frequently used for business or social activities Additional Notes About the Household Environment(Required)Misalnya: sering ada acara keluarga, aktivitas anak-anak yang aktif, atau kegiatan lain yang perlu diketahui pekerja.Contract Duration(Required) 1-Year Contract 2-Year Contract 3-Year Contract Working Start Time(Required) Hours : Minutes Working End Time(Required) Hours : Minutes Working Days(Required) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Days Off(Required) 1 day off per week 2 days off per month No days off Other Daily Rest Period(Required)Is the worker expected to work at night?(Required) Ya Tidak Please provide details of night-time duties(Required)Worker's Sleeping Arrangement(Required) Private Room Shared Room with Another Worker Other Worker's Room Facilities(Required) Suitable Bed Ventilation Wardrobe Bathroom Select AllWorker's Room Photo(Required)Max. file size: 1 GB.Food Arrangement(Required) Worker eats with the family Separate suitable meals are provided Worker prepares their own meals Nanny Job DescriptionChild's Name(Required)Child's Age(Required)Child's Gender(Required) Male Female Child Age Category(Required) Newborn (0–3 bulan) Infant (3–12 bulan) Toddler (1–3 tahun) Preschool (3–6 tahun) Newborn Care Job Description (0–3 months)(Required) Newborn care (safe handling, positioning, and bonding) Umbilical cord care and baby hygiene Bathing the baby using newborn care techniques Breastfeeding support (expressed breast milk handling) Preparing formula milk according to guidelines Sterilising bottles and baby equipment Managing newborn sleep routines Night shift (full overnight care) Soothing colicky or unsettled babies Monitoring baby’s condition (fever, jaundice, etc.) Awareness of newborn warning signs Ensuring safety 24/7 Select AllInfant Care Job Description (3–12 months)(Required) Bathing and maintaining baby hygiene Nappy changing and hygiene care Weaning preparation according to age and method Responsive feeding Maintaining feeding schedules Establishing sleep routines Basic sleep training Motor development stimulation (tummy time, crawling) Sensory and communication stimulation Tracking developmental milestones Select AllToddler Care Job Description (1–3 years)(Required) Preparing daily needs Maintaining child’s cleanliness and appearance Preparing children’s meals (balanced meals) Positive feeding approach Managing tantrums using positive methods Educational play activities (Montessori-based optional) Language and communication stimulation Gross and fine motor skills Toilet training Encouraging independent eating Developing basic independence Select AllPreschool Care Job Description (3–6 years)(Required) Managing daily routines Preparing school requirements Supporting light learning / homework Educational and creative activities Building discipline and responsibility Developing social skills Outdoor / activity supervision Screen time management School or activity drop-off and pick-up Travel / outing companion Select AllPreferred Nanny Skills(Required) No specific requirements Nanny with specialised certification (baby care / early childhood) Foreign language skills (English / Mandarin) Montessori / early education approach Sleep training specialist Newborn specialist (night nurse) Travel nanny Child's Allergies(Required)Child's Medical Conditions(Required)Preferred Parenting Approach(Required)Child's Habits and Routines(Required)Is there a co-parenting arrangement with a previous partner?(Required) Ya Tidak Does the child stay between two homes?(Required) Ya Tidak May the worker be required to assist when the child is staying with the other parent?(Required) Ya Tidak Child's visiting or living schedule with the other parent(Required)Is the worker also expected to assist with other household duties?(Required)Specific Expectations for the Worker(Required)Example: • Good timekeeping and punctuality • Experience in newborn or baby care • Cooking skills • Able to ride a motorbikeI hereby confirm that all information provided in this form is true, complete, and accurately reflects the actual conditions of my household. I understand that all information provided in this form will be used as the basis for the worker placement process and will serve as a reference for the company in selecting a suitable candidate. By providing my consent, I confirm that: I have provided accurate information regarding my household conditions, working environment, number of household members, presence of pets, scope of duties, and expected working arrangements. I understand that the information provided in this form will be used by the company to assess the suitability of the worker placement. I agree to follow the employment arrangement based on the information and requirements stated in this form. If there are any changes to my household circumstances, scope of duties, working arrangements, number of household members, or working environment in the future, I am responsible for informing the company before such changes are implemented with the worker. I understand that any changes which are not reported to the company may result in an unsuitable placement and may affect the continuity of the working relationship between the employer and the worker. I understand that if the information provided is found to be inaccurate or inconsistent with the actual circumstances, the company reserves the right to conduct a reassessment of the worker placement. By submitting this form, I confirm that I have read, understood, and agreed to all terms and information provided as part of the worker placement process.Signature(Required)