Declaration form for Biodata Application (Hong Kong)

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Declaration form for Biodata Application (Hong Kong)

HK Helper Health Declaration

Please enter your information

Your Full Name

Your Phone Number

Your HKID (i.e. A000000) or Passport Number

What is your highest education level that you completed?

Primary

Secondary

University

Bachelor

Master

Health Declaration

Do you have any allergies?

Yes

No

Please describe your allergies

Past and existing illnesses (including chronic ailments and illnesses requiring medication):

Mental illness

Yes

No

Epilepsy

Yes

No

Asthma

Yes

No

Diabetes

Yes

No

Hypertension

Yes

No

Tuberculosis

Yes

No

Heart disease

Yes

No

Malaria

Yes

No

Operations/Surgery

Yes

No

HIV

Yes

No

VDRL/Syphilis

Yes

No

Others:

Physical disabilities (if any):

Criminal Records and Loan Declaration

1) Do you have an ongoing loan or deduction with another employment agency?

Yes

No

2) Did you borrow money from money lenders in Hong Kong (licensed, or loan sharks)?

Yes

No

3) Have you gotten pregnant while working in Hong Kong?

Yes

No

4) Do you have current/previous issues with any government agencies (e.g. Labour Department, Immigration)?

Yes

No

5) Have you overstayed in Hong Kong without a working visa?

Yes

No

Declaration

*I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application or immediate termination of employment.