外國人預定工作內容說明書 Foreign Worker’s Job Description
※ 以上內容請以中、英文確實填寫，如有不實之情事者，將依相關法令論處。
雇主名稱
Name of Employer
可 承 接 名 額 Replacement Quota 工作所在地址
Work Location 工作類別 Type of Work：
（製造業需填寫 行業別 For manufacturing Industry, please fill in the specific field of manufacturing.
）
□家庭看護工In-home Caretaker □家庭幫傭 Housemaid □養護 機構Institutional Caretaker □漁工 Fisherman □製造業
Manufacturing Industry □營造工 Construction Worker □其他 Others
工作內容 Duties &
Responsibilities
（請詳細說明 Please be specific.）
◎家庭類Household Type：
1.被看護者性別 Gender of Care Recipient：
□ 女Female □ 男 Male
2.年齡 Age：________歲 Years Old
3.被看護者身體狀況 Physical Condition of Care Recipient：
□植物人 Persistent Vegetative State Patient □老人癡呆
Alzheimer's Disease □中風 Stroke □智能不足 Mental Retardation
□精神異常 Mental Disorder □癌症 Cancer □傷殘 Disability □插 管 Endobronchial Intubation □全癱 Whole Body Paralysis □半身 癱瘓 Paralysis of One Half of the Body □截肢 Amputation □其 他類Others＿ (與診斷書病名相同 The disease name should be the same as one stated on the medical certificate. )
4.工作內容 Duties & Responsibilities
□煮飯 Cooking □幫忙洗澡 Shower Assistance □按摩及拍背 Massage & Patting □餵食 Feeding □協助坐輪倚 Wheelchair Assistance□協助大小便 Bowel and Bladder Assistance □陪同就 醫 Accompanied to Medical Visit □其他 Others (依規定不得涉 及專業醫療行為之照護工作 )
◎非家庭類Non-household Type：
工作內容Duties & Responsibilities：
勞動條件 Labor Conditions
1.工作時間 Working Hours：______時 Hour/天 Day
2.薪 資 Salary：月薪 Monthly Pay$____________；加班費 Overtime Pay $______/時 Hour
3.休假制度 Leave Benefit：____天 Day/____月 Month
(若無休假，則給付加班費$______/天 Employer has to pay overtime $____/day to the worker who works during his/her time off)
4.福利制度 Benefits：__________________________________
5.其 他 others：__________________________________
附註P.S.：
以上工作內容，目前有□男性□女性 從業人員從事工作
□ Male
□ Female (check if applicable) workers are currently employed to
engage in the above-mentioned job duties. 9808 版 AF-T11
Please fill out the form in both English and Chinese. Any false or misleading statement may be penalized according to relevant law.
