EMPLOYMENT APPLICATION FORM

DATE OF APPLICATION POSITION APPLIED FOR: BASIC PAY

DESIRED:

FAMILY NAME FIRST NAME MIDDLE NAME NICK NAME

PERMANENT ADDRESS: TELEPHONE/CELLPHONE NO:

TEMPORARY ADDRESS: SEX:

MALE
BIRTH DATE: AGE: CITIZENSHIP: RELIGION: HEIGHT: WEIGHT:

BIRTH PLACE: SSS NO. TIN NO.

CIVIL STATUS:

Single Married Separated Widow

NAME OF SPOUSE: DATE OF BIRTH: OCCUPATION:

NAME OF DEPENDENTS DATE OF BIRTH: RELATIONSHIP:

PARENTS NAME: ADDRESS: OCCUPATION:

Father:
Mother:

EDUCATIONAL BACKGROUND

HONORS/AWARDS
SCHOOL FROM TO DEGREES ACHIEVED

LICENSES OR CERTIFIED MEMBERSHIP TO ANY TRADE/PROFESSION

TYPE DATE OF ISSUE

IN-SERVICE / ON-THE-JOB TRAINING / SEMINARS ATTENDED

COURSES/TITLE COMPANY AGENCY INCLUSIVE DATE

OTHER
QUALIFICATIONS:

LICENSES MEMBERSHIP
OR CERTIFIEDINMEMBERSHIP
CLUBS, ORGANIZATIONS
TO ANY TRADE/PROFESSION
& ASSOCIATIONS

NAME OF ORGANIZATIONS POSITION HELD INCLUSIVE DATE

HOBBIES & RECREATIONAL ACTIVITIES:

Human Resources and Administration Department

/CELLPHONE NO:

FEMALE

CCUPATION:

HONORS/AWARDS
RECEIVED

RATING

INCLUSIVE DATE
INCLUSIVE DATE
 EMPLOYMENT APPLICATION FORM
PERSONAL REFERENCES
(List at least three (3) persons not related to you who are familiar with your qualification and character.)

FULL NAME: ADDRESS: CONTACT NUMBERS:

COMPANY: POSITION

FULL NAME: ADDRESS: CONTACT NUMBERS:

COMPANY: POSITION

FULL NAME: ADDRESS: CONTACT NUMBERS:

COMPANY: POSITION:

Have you ever been charged or convicted of any crime? If yes, state nature.

Have you ever filed a case of labor, civil and/or criminal case? If yes, when and why?

Do you have existing liability with friends, money lenders, banks, credit card, pawnshop, etc.? If so, please specify.
TYPE OF LIABILITY COMPANY AMOUNT

Have you ever become insolvent or failed in business? If so, please give particulars.

How are you going to handle the situation if in case one of your family members got sick? What specific action are yo
going to do in order not to affect your job performance?
What possible reason or situation will prevent you from reporting to work? Why?

MEDICAL HISTORY

Have you taken a recent physical examination? When and for what purpose?

Any defect in speech_______________? Hearing______________? Sight__________________? Feet_______________

How much time have you lost through illness during the past two (2) years?

What is the present condition of your health?

Are you willing to take a physical examination?

PRE-EMPLOYMENT STATEMENT

I voluntarily give the company the right to make it thorough investigation of my past activities and release from all liabilities the parties
supplying such information. The company may use this information in any manner itmay wish. I consent to take all examinations the
company requires. Falsification and/or misrepresentation will be enough basis for termination:
APPLICANT'S FULL SIGNATURE DATE:

Human Resources and Administration Department

 CONTACT NUMBERS:

CONTACT NUMBERS:

CONTACT NUMBERS:

? If so, please specify.

TERMS

at specific action are you

? Feet________________?

bilities the parties

aminations the
 EMPLOYMENT APPLICATION FORM
WORK EXPERIENCE
(Start with last or present employer)

COMPANY NAME: ADDRESS:

REASON FOR LEAVING JOB SUMMARY:

IMMEDIATE SUPERVISOR HRD HEAD / PERSONNEL

COMPANY NAME: ADDRESS:

REASON FOR LEAVING JOB SUMMARY

IMMEDIATE SUPERVISOR HRD HEAD / PERSONNEL

COMPANY NAME: ADDRESS:

REASON FOR LEAVING JOB SUMMARY

IMMEDIATE SUPERVISOR HRD HEAD / PERSONNEL

Have you ever been discharge / or requested to resign in any position? If so, please explain.

Have you been subjected to any disciplinary measures?

Are you related to anyone working for us? If yes, give name(s) and relationship(s)

If ever hired, when can you start?

Have you declared the complete history of your employment? If no, you may use separate sheet to enumerate the res
of the information needed.

Do you have any pending applications from other company or abroad? If yes, please enumerate.

Are you amenable to be relocated in Pampanga? If no, why?

Human Resources and Administration Department

 MONTHLY SALARY
Initial Final

LENGTH OF SERVICE
From To

MONTHLY SALARY
Initial Final

LENGTH OF SERVICE
From To

MONTHLY SALARY
Initial Final

LENGTH OF SERVICE
Initial Final
eparate sheet to enumerate the rest

se enumerate.