What is your full name? *
When is your birthday or how old are you?
Gender
Are you male or female?
Male
Female
Unknown/Other
Country of origin
What is your nationality?
Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo Congo Democratic Republic Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Northern Ireland Norway Oman Pakistan Palau Palestinian State Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Samoa San Marino Sao Tome & Principe Saudi Arabia Scotland Senegal Serbia and Montenegro Seychelles Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Kitts and Nevis St. Lucia St. Vincent - Grenadines Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe
Employment status
Are you a documented or undocumented migrant worker?
Regular
Undocumented
Other
Occupation
What kind of work do you do?
Agricultural Worker
Apprentice/Trainee
Businessman
Caregiver
Construction Worker
Dentist/Dental Aide
Doctor
Domestic Worker
Engineer
Entertainer
Factory Worker
Lawyer/Legal Aide
NGO/Development Worker
Nurse/Nursing Aide
Physical Therapist
Seafarer
Secretary/Clerk
Student
Teacher
Technician
Other categories
Additional Information