Sun Plaza Bldg., 1507 Shaw Blvd., cor.

Princeton Street
Brgy., Wack-Wack Mandaluyong City PHOTO
PHOTO

JOB APPLICATION FORM

___________________
DATE POSITION APPLIED

A. PERSONAL

NAME __________________________________________________________ __________ __________ _____________ _______________

SURNAME FIRST MIDDLE AGE SEX HEIGHT WEIGHT
CITY ADDRESS ____________________________________________________________________________________________________
____________________
TEL. # _______________ SSS # ________________ TIN # _________________PAGIBIG # _______________ PHILHEALTH #__________
__________
BIRTHDAY ______________________________ BIRTHPLACE _____________________ RELIGION_____________________
PROVINCIAL ADDRESS ____________________________________________________________________________________________
____________________________
PASSPORT NO ____________________ PLACE ISSUED____________ DATE ISSUED_________ EXPIRATION DATE______________
DESIRED SALARY /Month WHEN CAN YOU START TO WORK?____________________________________

B. FAMILY

________ SINGLE _________ MARRIED ________ WIDOW ________ SEPARATED

NAME OF SPOUSE ___________________________________________ OCCUPATION ____________________________

NO. OF CHILDREN ______________________ BROTHERS _______________________ SISTERS________________________
FATHER _______________________________________________________ OCCUPATION ____________________________
MOTHER ______________________________________________________ OCCUPATION ____________________________
ADDRESS __________________________________________________________________ TEL. NO. ______________________
DO YOU _____ OWN YOUR HOME? ______RENT? _____ LIVE WITH RELATIVES? _____WITH FRIENDS _____BOARD?
HOW MUCH MONTHLY RATE DO YOU PAY? ______________________ DO YOU OWN A CAR ______ YES ______ NO
DO YOU CARRY LIFE INSURANCE? ________ NO _______ YES AMOUNT P___________________________
WHAT PHYSICAL DEFECTS DO YOU HAVE, IF ANY? ____________________________________________________________________
________________________________________________________
LIST NAMES OF FRIENDS/RELATIVES PRESENTLY EMPLOYED WITH THIS COMPANY _____________________________________
__________________________

C. EDUCATION

SCHOOL DATES ATTENDED COURSE/DEGREE HONORS RECEIVED

ELEMENTARY _________________________________________________________________________________________________________
_______________________________________________________________________________________________
HIGH SCHOOL ________________________________________________________________________________________________________
______________________________________________________________________________________________
COLLEGE _____________________________________________________________________________________________________________
__________________________________________________________________________________________________
GRADUATE SCHOOL __________________________________________________________________________________________________
________________________________________________________________________________________
LICENSURE EXAM TAKEN __________________ LICENSE NO.____________ DATE/PLACE ISSUED: ________________
DATE OF LAST PAYMENT, PROFESSIONAL TAX: ________________ __________________________________________________________
SPECIAL SKILLS/OTHERS ______________________________________________________________________________________________
___________________________________________________________________________________

D. EMPLOYMENT

COMPANY POSITION MONTHLY SALARY DATES REASONS FOR LEAVING

E. CHARACTER REFERENCES

NAME OCCUPATION ADDRESS TEL. NO.

NOTE : PLEASE ANSWER EACH OF THE FOLLOWING QUESTIONS ON A SEPARATE
SHEET OF PAPER

1. Give candid description of yourself as a person discussing in order of importance what you feel are
your greatest assets and liabilities.

2 Briefly describe what you believe to be your most substantial accomplishment to-date, explaining
why you view them as such.

3. List the vocation or professions, other than your present one, which you may have seriously
considered. Give the reasons for your interest in them, stating why you ultimately chose your
present profession.

4. Please relate one or two significant incidents in your life which you feel you were greatly responsible
for. These situations may be taken from school, business, community, or military life. Describe
how the situation developed, explain your part in it, and what did you gain from the experience.

5. Why do you choose to apply in Chiyoda Philippines Corporation?

6. What are your plans for your career development/advancement? In what specific ways do you
feel your employment with this company will help you attain these plans?

I HEREBY CERTIFY THAT ALL INFORMATION GIVEN HEREIN ARE TRUE

AND CORRECT AND I FULLY UNDERSTAND THAT ANY FALSE STATEMENT
PRESENTED HEREIN WILL CONSTITUTE SUFFICIENT CAUSE FOR MY IMMEDIATE
SEPARATION FROM EMPLOYMENT WITH THIS COMPANY.

I FURTHER AUTHORIZE CPh CORPORATION TO INVESTIGATE ALL FACTS

CONCERNING MY SKILLS, HABITS, CHARACTERS, BACKGROUND AND SUCH OTHER
INFORMATION DEEMED PERTINENT TO MY QUALIFICATIONS FROM THE
FOLLOWING SOURCES:

MY PRESENT EMPLOYER MY SCHOOL MY NEIGHBORHOOD

MY PREVIOUS EMPLOYER MY REFERENCES ALL OTHER BACKGROUND SOURCES

______________________________

SIGNATURE