APPLICATION SHEET

Personal Data
POSITION APPLIED FOR: SECOND OPTION:

1. Name (Last Name/Middle Name/First Name): Please print

2. Present Address: Contact Nos.

3. Provincial Address: Citizenship

4. Place of Birth: Age:

5. Date of Birth: Civil Status:

6. Sex: Height: Weight: Distinguishing Marks:(if any)

7. Spouse: (Last Name/Middle Name/First Name): Please print

8. If Spouse is employed, state his/her EMPLOYER and ADDRESS

9. Number of children and their ages:

10. Number of Dependents: SSS No.: TIN No.:

11. Father's Name: Occupation: Address:

12. Mother's Name: Occupation: Address:

13. Educational Background:

School Attended Location Degree Inclusive Dates

14. Nature of Employment Desired:

15. Salary you will consider:

16. Name of friends/relatives employed by this company (State relationship)

17. What machines do you operate:

18. Special knowledge/skill training:

19. Have you ever been investigated by any police agency before? If so state the reason and the result.

20. Have you ever been charged or convicted for violation of any law, ordinance or regulation?

21. Do you have any physical defect of illness at present? (If so, please state)

Form No.: HRD-FRM-03 R0 Ref Doc No.: HRD-PRO-01

 APPLICATION SHEET
22. Have you ever been seriously ill berfore? (if so, please state the cause)

23.Have you ever been hospitalized for the last 5 years? (What is your last illness and its cause)

24. Do you smoke? Drink alcoholic beverages? Play card games, majhong, etc.? How often?

25. References, not relatives or former employer:

Name Occupation Address/Contact No.

26. Previous Employment

Inclusive Date Name of company Address Position Held Salary Reason for leaving

27. Whom shall we notify in case of emergency:

Name Relation:

Address Contact No.:

I authorize any former employer or any reference to answer all questions or furnish any information
requested in this application for employment.

I understand that falsification of documents or a misstatement or misrepresentation of the truth to

obtain employment, will be a cause of my immediate dismissal.

I also understand that I will initially be employed as a casual employee for six months if my
application for employment is accepted.

Date: Certified true and correct

Witness:

Signature of Applicant

(This space is to be filled in by Personnel Dept.)

Employed on __________________ As _________________________ Salary _________________

Department _________________________________________________________________________
Remarks:

Form No.: HRD-FRM-03 R0 Ref Doc No.: HRD-PRO-01