MAID REQUEST FORM Please fill in the form below. Our representative will assist you on the recruitment process. All fields marked with a * are required: I need a domestic helper for (Primary Responsibility)   Child Care Elderly Care Home Care No Preference Age Range   No Preference 25 to 30 31 to 35 36 to 40 41 to 50 Nationality No Preference Indonesia Religion   No Preferences Muslim Buddhist Hindu Christian Education Level   No Preferences Primary Secondary College Marital Status No Preferences Single Married Widowed Divorce   Your Particulars Your Name * --- Select One --- Mr. Ms. Mrs. Dato / Datuk Others Address * Email * Office Telephone No. Home Telephone No. Mobile Phone No. Other Inquiries

WHITE GLOVE SDN BHD (685249-W)
1-2, 2nd Floor, Jalan 3/76D, Desa Pandan,
55100 Kuala Lumpur, Wilayah Persekutuan, Malaysia.

Tel: +603-9281 0068
Fax: +603-9281 0062

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