401411E1

1441M / Additional Infyrmation

i. SuantnIunnilallulaSsmat laiinriaiminorialaumulaamilounlalti Dilalinn 0 ma 0 thway

a „...1 TOA-DOVECHEM INDUSTRIES CO., LTD.
Have yea even Peen operated. seriously M. contact with collieRlithe disaster No Yea Please Specify
TOA TDIC.
anew hospitrinanon
iiiiuSnaglatatiitintallinaammilati IlSina 0 ma 0 thorny
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Do you have any physical handicap 7 iNa Yes Mori Spray
tinnatignmaininnallainmalmailetl 186 %Imo 0 MD 0 Ithirrai eriintriimpir t.
.a Nave you ever had legal action taken aping you 7 No 1 es Please specuy Position Applied LQ9, 5.11C (As' ci 51-01
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Do you Drink alcoholic beverage? Na Yes

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Name :
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an you work overtime ? Na C Yea Mr./Mn/tilise ki 001106.0Nit Chtiantr 0 A1gqe 9,,, $ Height I 1 / weight V— 1
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iyaraeAuntil Date of Birth 17 17 114 Place of Riffle/VI I 1\4;1411 Blood Type 0
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ID Card No. (11070115CM 0 iss
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I certify and understand ythal . nallIMP4111111 0 liel 0 laitaa
I certify that all statements given in this application form are true. hand is found to be mine or falsify after the Milillary Status Completed Military Service Has Not Con pitted sumary Service
engagement the company has the right ot terminate mey employment without any compensation or severance pay whatsoever.
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Anuniuvaiiiisirmlogi nisinspoilimii / Hiring Detail Contactr
(Direct Supervisor's °plow)) i„„v,,,; ,, 66

/Working, Training Experience

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Job Description
nitre / / ihn i Department :

Signature
ii3iiii 'Company :
/11741(1111tri5lelORi4 thritifilli12111 / Previous Employment
Ulli MEM / Tii
141114014 /salary : at
Direct Supervisor Rath Month / Day ling1101 1.111111 61111011 illithll innigilean
Company Name

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A From / To Position Salary Hearin For Leaving ,
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tillYill1U Orin() itill / Starting Date 6 iti‘PLI 5 PWII P Ubl..1 e fOrcei AOTAV 1°K$3 06110‘iv IP& tie
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Signature Signature Signature
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Department Head Human Resources Department Managing Director Q6Clgi 0
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Marital Status Single Married Widowed Separated Other Level of Education Institute From To CPA. Degree Major
pailouttusinsall aeilpil ean14 op. filrOante 1

BUM! flhJMtll /Education andTraining Background

Marriage Certificate No.
Olympias Wel
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leaned At.
14 5"
FrimaII Filw°1
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No. of Children Male Female Secondary School 71/6) 0-a n kit 9.C5 L
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Pint Child, Name lieu of With Vocational
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Second Childs Name mile of Brich moon.
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i Age Occupation Company / Institute Phalle No. Other
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Husband /Wife Dam / Month /Year
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Brothers / stolen del IL If Mud ing, please NATIO institute (Sal Including Yonrself)
tit le -no nsuplYstauf nui ennetlihent /nano; Instina
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Company Itelationshirl 5
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Pnallion Phone No. pa Driver Dome No. Yes No Permanent Temporary Diver !Jo/neeNo. Yee No Permanent Temporary
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Please name any acquaintant in TOA Group Some RelatIonehlp Driver's License Not nolverb License No.

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slow did you know about Job vacancy ? ID fil Von (HD L 1/1
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rionnauenntinuninu Duailip
Public activity / menthersilIP Hobby I Interest
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5%-wan niKenitifiRgolnitwfrititritivnu
tatrirgnp thvnivii-drufwi (rnrimnisitAtiAneruicniTfitarmtuflu) Serial Number: 23050042331
11411301 loltn tnvonitiu iniltirm Into L0/010814 -mu9tmor Lniqc
annting ninniAnw1ihnn2562 nimazufli : 2/2563
BA60101 rmininnifisnninnimils 3 8+ EN58207 : 0383f74086A60-111c14314 2 D+

BA60205 : rminnithziiiniutansieniu 3 1060301 : nis4114614611-4iuk1 3 13+

EN58101 : arnotiluntvotru 2 A 10e0302 : niqranit4in4iustni14bIfi 3 13+

TH58101 : niwansolemilttni 3 I.M60204 : nirtitinomuntirinkanisZinniaa;griniinisagiJ 3 C

CR : 11 Cs: 11 OR: 33.5 SPA : 3.05 CRX: 11 CSX II GPX : 33.5 GPAX :3.05 1M60209: ntnisufnimarNunirtoinittarisiinita--nummrwm 3 13+
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8381.1391.10: 1/2562
1M80305: warnmAtTimpinirtwiNtlumia 3 e+
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8A60263 : nitiligguTuinOimrtnnitgrag 3 CR: 17 CS: 17 GP : 51 CPA : 3.00 CRX: 82 CSX : 82 GPX: 236.5 GPAX: 2.88

EN58102 : niutET4nrollunpth 2 B+ rnMmu3 : 1/2564

HM58102 : manniturruniimulAgimilA 3 C1458101 : inv1ui4an1?tatin 1 3

1M60106: nitiltn.inimilptinkluniriBri-mtatmainiusiznimuluiAm 3 A 1060303 : nitutwirent

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5058104 : msattailufounimlmsi 3 c+ LM60310 : inviisuirnmilnkuni44rAnitIsilintilmiznilomarew 3 B+
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CR : 20 CS : 20 GP : 65.5 CPA : 3.28 CRX : 31 CSX: 31 GPX : 99 GPM 3.19
CR : 15 CS-{15
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flIAL1SIJII : 2/2562
BA60307 : innua1simitOen9141irruipli c+ zyweit040 : 2/2564
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1M60101 : nir4'eniinivauli4usznimiz•naiimii CH58102 : nitnrkaAsnilturil 2 3

1M60107 : „pi 1111431 HM58106 : wntnifunwhivmouriviiia 3 A

11E114 2 1060404: imaiwunmalmakalvuttliaini 3 B+

5C58105: wroginhaiittArnainsimastittar, 3 LM60311 : ninlaufnintlaiiiiiiurnvinnithrisiiniustrnuonniu 3

5058101 : 4ninnImu5tanimunimm414641 3 VAC 6

CR : 17 CS : 17 GP: 47.5 CPA : 2.79 CRX :48 CSX : 48 GPX 46.5 GPAX : 3.05 CR :15 CS: 15 CR: 46.5 GPA : 3.10 CRX : 112 CSX : 112 GPX: 325 GPAX : 2.90

n-wnit4nA: 1/2563 : 1/2565

BA60204 : 3 1M60412: mitimujnistifitWitini iiirnitegoiniusznitrominu 3 A

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EN58206: 033,441-8011.1120190-68188811:018111811118.48AN 2
tutu 8
LM60202 0188111032114184894 3 C
3 C CR 9 CS 9 GP : 36 CPA : 4.00 CRX: 121 CSX: 121 GPX 361 GPAX : 2.98
LM60203 018TUIST111111114016k1140114iNnit8tini

LM60208 : 3 C+ ,RwriumusimutiniAnitti
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CR : 17 CS 17 GP : 39 GPA : 2.29 CRX : 65 CSX : 65 GPX : 185.5 GPAX 2.85

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