TEST RESULT

Rating:
PERSONAL DATA SHEET PHOTO

Equivalent:

PERSONAL DATA (Please Print)

Name (Last) (First) (Middle) Nickname
GAlAITES JOHN JOHN MANZANO JOHN

Present Address (No.) Street City or Province Telephone

DARAPIDAP, CANDON CITY, ILOCOS SUR 09159791615

Permanent Address (No.) Street City or Province Telephone

DARAPIDAP, CANDON CITY, ILOCOS SUR 09159791615

Date of Birth Place of Birth Religion Age Sex Status Ht. Wt.
09/06/1993 CANDON CITY, ILOCOS SUR ROMAN CATHOLIC 26 MALE MARRIED 5”7’ 58

Nationality If Alien, ACR No. Passport No. Issue Date of Passport Do you own a car? Do you drive? Do you have a valid driver’s license?
FILIPINO yes no
yes no yes no if yes, indicate license no.
Tax Identification No. SSS No. PhilHealth No.

742-200-309-000 01-2260288-1 05-050217189-2

Special Talents Language Spoken/Understood
TAGALOG, ENGLISH, ILOCANO

Computer Knowledge Hobbies/Interest/Sports

COMPUTER HARDWARE SERVICING

EDUCATIONAL BACKGROUND
Name of School Address of School Period Covered Awards/Honors/Citations
ELEMENTARY
DARAPIDAP ELEMENTARY SCHOOL DARAPIDAP, CANDON CITY, ILOCOS SUR

HIGH SCHOOL
CANDON CITY HIGH SCHOOL DARAPIDAP, CANDON CITY, ILOCOS SUR

COLLEGE Course/Major/Minor
ILOCOS SUR POLYTECHNIC STATE COLLEGE TAGUDIN, ILOCOS SUR WEB TRACK

VOCATIONAL/TECHNICAL Details

POST GRADUATE Details

Government Exams Taken - Date/Rating:

(Indicate license no.)

TRAINING/PRACTICUM/RESEARCHES
Title Dates Remarks/Details

Title Dates Remarks/Details

CO-CURRICULAR/EXTRA-CURRICULAR ACTIVITIES/GROUP ASSOCIATIONS

Group Name/Activity Period Covered Position Held Remarks

EMPLOYMENT HISTORY (From present to previous)

Name of Company Address Tel. No. Nature of Business Reason for Leaving/Resigning
I.V.S AUDITING OFFICE CANDON CITY, ILOCOS SUR NEW OPPORTUNITIES

Entry Position Period Covered Basic Salary Allowances Others Name of Supervisor
OFFICE STAFF/ COMPUTER MAINTENACE 2018-2020 10,000 JEANINI GALDONES

Last Position

Name of Company Address Tel. No. Nature of Business Reason for Leaving/Resigning
ONLINE LAUNCHING BAGUIO CITY FINISH CONTRACT

Entry Position Period Covered Basic Salary Allowances Others Name of Supervisor
2017-2018 8000 SHEERA MAINE MANZANO

Last Position

Name of Company Address Tel. No. Nature of Business Reason for Leaving/Resigning

Entry Position Period Covered Basic Salary Allowances Others Name of Supervisor

Last Position

Name of Company Address Tel. No. Nature of Business Reason for Leaving/Resigning

Entry Position Period Covered Basic Salary Allowances Others Name of Supervisor

Last Position
How soon can you start?
Salary desired:
Immediately End of the month Days after notification :
10000
FAMILY DATA
Spouse’s Name Address Company Name/Position Age Living
ANNA ERICA GALAITES DARAPIDAP, CANDON CITY, ILOCOS SUR 26 Deceased

Father’s Name Address Company Name/Position Age Living

ELPIDIO G. GALAITES DARAPIDAP, CANDON CITY, ILOCOS SUR 58 Deceased

Mother’s Name Address Company Name/Position Age Living

MELANIE M. GALAITES DARAPIDAP, CANDON CITY, ILOCOS SUR 55 Deceased

Brother/Sister Address Company Name/Position Age Single

ELLENMAE GALAITES DARAPIDAP, CANDON CITY, ILOCOS SUR 18 Married

Brother/Sister Address Company Name/Position Age Single

JOHN REY GALAITES DARAPIDAP, CANDON CITY, ILOCOS SUR 22 Married

Brother/Sister Address Company Name/Position Age Single

JUMEL GALAITES DARAPIDAP, CANDON CITY, ILOCOS SUR 28 Married

Brother/Sister Address Company Name/Position Age Single

EMELYN GALAITES DARAPIDAP, CANDON CITY, ILOCOS SUR 32 Married

Brother/Sister Address Company Name/Position Age Single

Married

Brother/Sister Address Company Name/Position Age Single

Married

CHILDREN/DEPENDENTS
Name Age Relationship Name Age Relationship
JERICHO G. GALAITES 5 SON

Name Age Relationship Name Age Relationship

HANNAH G. GALAITES 4 DAUGHTER

CHARACTER REFERENCES - not former employers or relatives

Name Business Address or residence Tel. No. Occupation
NESTOR GALANO DARAPIDAP, CANDON CITY, ILOCOS SUR BRGY. KAGAWAD

Name Business Address or residence Tel. No. Occupation

JOHN APELADO DARAPIDAP, CANDON CITY, ILOCOS SUR BRGY. KAGAWAD

Name Business Address or residence Tel. No. Occupation

EDUARDO VILLANUEVA DARAPIDAP, CANDON CITY, ILOCOS SUR BRGY. CAPTAIN

FRIENDS AND RELATIVES EMPLOYED WITH THIS COMPANY OR ITS SISTER COMPANIES
Name Relationship Position Company

Name Relationship Position Company

ADDITIONAL INFORMATION:
1) Have you ever been convicted of a crime involving moral turpitude? Yes No
If yes, please specify

2) Do you have any pending administrative / criminal / civil case before any court or quasi-judicial body?
Yes None If yes, please give details.

3) Were you ever treated for any communicable diseases, alcohol, or drug use? Yes No
If yes, please specify.

4) Are you aware of any physical condition that may hamper your ability to discharge your work responsibilities?
Yes No If yes, please give details.
5) Have you undergone any minor or major operations? Yes No
If yes, when? Please specify.

6) Have you been issued clearance from all your previous employment? Yes No
If no, why? Please specify.

IMPORTANT NOTICE: Non-submission of clearance from your previous employment within 3 months
from date of hire shall affect your employment status.

All the information I have supplied in this form are, to the best of my knowledge, true and correct. I understand that any contract or agreement entered between the
Company and me will be predicated upon the truthfulness of the statements contained herein. I understand further that any deliberately untrue information given can
become a basis for my dismissal if/when hired.

If employed, I promise to undertake and abide by the rules and regulations set and prescribed by this Company, including transfers and assignments to other location or
subsidiaries the company deems best, and adherence to the provisions of Republic Act No. 1405, an act prohibiting disclosure of or inquiry into deposits with any banking
institution and the penalty provided therein.

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Applicant’s Signature

ATTENTION : Head – Human Resource Management

Gentlemen:

This shall serve as my formal authority to disclose to Summitsuperbikes Corp. / Premiumbikes Corp. or its duly authorized Background Investigation agency any matters pertaining to my
previous employment with you for purpose of conducting pre/post employment background checking.

Very truly yours,

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Signature over Printed Name Date of Filing