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EVP Registration Form
CFO registration form for EVP participants
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: COMMISSION ON FILIPINOS OVERSEAS
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INFORMATION SHEET FOR AU PAIR PARTICIPANTS (AU PAIR VISA HOLDERS)
INSTRUCTIONS : Please PRINT letters in the spaces provided.
Please CHECK () appropriate box(es).
(FOR CFO USE ONLY)
AU PAIR no.
OR #
-
Reg. Date [ mm-dd-yy ]
-
Verifier
PERSONAL DATA
Last Name
Suffix
First Name
Middle Name
If married, please state mother's maiden name
DATE OF BIRTH [ mm-dd-yyyy ]
AGE
SEX
CIVIL STATUS
Male Female
Divorced
Single
Widow(er)
Married
Separated
Outside of the Philippines
PLACE OF BIRTH
Town / City
Province/ State
Country
ADDRESS & CONTACT NUMBERS IN THE PHILIPPINES
NOT FOR SALE
House No. / Street / Barangay
Town / City
Province
Telephone Number
Cellphone Number
Zip Code
E-mail Address
ADDRESS & CONTACT NUMBERS (Country of Destination)
House No. / Street
City / State
Country
Zip Code
Telephone Number
Cellphone Number
E-mail Address
PASSPORT NUMBER
DATE OF ISSUE [ mm-dd-yyyy ]
VISA NUMBER
DATE OF ISSUE [ mm-dd-yyyy ]
HIGHEST EDUCATIONAL ATTAINMENT
High School Level
High School Graduate
Vocational Level
Vocational Graduate
AS OF MAY 2012
College Level
College Graduate
Post Graduate Level
Post Graduate
If vocational / college / post graduate, state course
School Name
Address
ECONOMIC STATUS
Employed
Self-employed
Unemployed
If employed / self-employed, state profession / occupation / business
If unemployed, check the appropriate box
Housewife
Student
Out-of-school youth
Not reporting any occupation
INFORMATION ABOUT SPONSOR / HOST FAMILY
Name of the head of the Host family
Address abroad
Occupation
Telephone Number
Cellphone Number
E-mail Address
IN CASE OF EMERGENCY-DATA OF NEAREST FAMILY MEMBER IN THE PHILIPPINES
Name
Relationship
Address
Zip Code
Telephone Number
Cellphone Number
FUNDING SOURCE
E-mail Address
MODE OF INTRODUCTION TO THE HOST FAMILY
Philippine Government
Private company / organization
Agencies
Personal
Host Family
Personal Introduction
Referred by Family/Relatives
Recruitment Agency*
Thru Internet*
If funded by any organization/agency/training center/company
Thru Organization*
please state the name and indicate its contact information:
Thru Foreign Post*
Training Center/Agency/School
Others*
*please specify
As prescribed in the Guidelines on the Departure of Au Pairs to Europe (signed in February 2012), an au pair is a young Filipino citizen
between 18 and 30 years of age, unmarried and without any children placed in an immersion program in cultural and language training
in a specific European country of destination. He/She shall live with the host family at par (au pair) or on equal basis with immediate
members of the host family, shall be given pocket money, share in child care, light household chores and responsibilities previously
agreed upon in an au pair placement contract between the au pair and the host family.
LIMITATION OF STAY:
Based on the European Agreement on Placement of Au Pairs (November 1969), an au pair is placed under a cultural exchange
arrangement with the European host family for a maximum stay of two years, unless otherwise allowed by the host country.
CERTIFICATION
I have read and understood the foregoing. I understand that it is my responsibility to maintain my Au Pair Status. I certify that
all the information on this form is true and correct to the best of my knowledge.
SIGNATURE ABOVE PRINTED NAME
THIS FORM IS NOT FOR SALE
