DOLE-AKAP Application Form OFW Details All details are required Last Name First Name Middle Name Your Email Mobile Number Facebook Account Birthdate Sex —Please choose an option—MaleFemale Passport No. Country —Please choose an option—ItalyMaltaAlbania Region —Please choose an option—AbruzzoBasilicataCalabriaCampaniaLazioMarchéMolisePugliaSardegnaSiciliaToscanaUmbria Address in Host Country Philippine Address Are you currently in the Host Country? YesNo Were you able to acquire an OEC before? YesNo Are you an Active Member of OWWA? YesNo Employment Details Employer Name Employer Address Employer Contact Number/E-mail Occupation of OFW Displacement Details Displacement Status TerminationCassa IntegrazioneLeave without Pay/SuspensionPlaced on paid quarantine/sick/vacation leaveShortened HoursStill Working Date of Displacement (Kailan ang huling pagpasok sa trabaho) Please answer the following: Please answer truthfully. Misrepresentation can be a ground of disqualification. Do you still have another employment or work at this time? (May ibang employer ka pa ba?) YesNo Are you still receiving salary from your employer/s? (Nakakatanggap ka pa rin ba ng sahod galing sa amo mo?) YesNo Are you receiving or are you entitled to receive financial assistance from the Italian Government under the Cura Italia decree? (Nakatanggap ka ba o kwalipikadong mag apply ng ayuda galing sa Gobyerno ng Italia o Cura Italia?) YesNo Are you receiving or are you entitled to receive financial assistance from the Maltese Government? (Nakatanggap ka ba o kwalipikadong mag apply ng ayuda galing sa Gobyerno ng Malta) YesNo Documentary Requirements Please upload the files in jpg or pdf format Passport Work Permit (Permesso di Soggiorno, Carta di Soggiorno) Proof of Displacement (i.e., Lettera di licenziamento or Certificazione dal datore di lavoro+Carta Identita of Employer, etc.) Terms and Conditions Please read carefully before accepting. I hereby certify that the information given herein are true and correct to the best of my knowledge and I understand that any misrepresentation or false information submitted shall be a ground for disqualification of my application. By submitting your application, you consent to the collection, generation, use, processing, storage and retention of your personal data by the Department of Labor and Employment (DOLE) and Overseas Workers Welfare Administration (OWWA) for the purpose of your application for the FINANCIAL ASSISTANCE FOR DISPLACED LANDBASED AND SEABASED FILIPINO WORKERS AFFECTED BY THE CORONAVIRUS DISEASE (COVID-19) "DOLE-AKAP for OFWs". Signature Please sign below [signature* sig] Please review before clicking submit Δ
