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Ref. No.
APPLICATION FORM Date

Do not fill up, for interviewer's use

NAME OF INTERVIEWER EVALUATION/REMARKS

RECOMMENDATION:
QUALIFIED FOR FURTHER EVALUATION FOR FUTURE VACANCY NOT QUALIFIED
IF HIRED, DATE TO START WORK POSITION STARTNG SALARY DEPARTMENT/PROJECT

APPLICATION FOR EMPLOYMENT

FIRST CHOICE SECOND CHOICE

POSITION APPLIED FOR: RECENT

PHOTO
EXPECTED SALARY DATE YOU CAN START FOR WORK DATE OF APPLICATION
HERE
120K - 100K ##

I. PERSONAL DATA
FAMILY NAME FIRST NAME MIDDLE NAME

PROVINCIAL ADDRESS CITY ADDRESS E-MAIL ADDRESS TELEPHONE/CELLPHONE

HEIGHT WEIGHT DATE OF BIRTH PLACE OF BIRTH CIVIL STATUS RELIGION

NAME OF SPOUSE ADDRESS OCCUPATION TELEPHONE/CELLPHONE

TAX IDENTIFICATION NUMBER (TIN) SOCIAL SECURITY NUMBER (SSS) PHILHEALTH NUMBER HDMF/PAG-IBIG NUMBER

II. ACADEMIC AND PROFESSIONAL QUALIFICATION

A. EDUCATIONAL RECORD
COMPLETED? INCLUSIVE YEARS

NAME OF SCHOOL AND ADDRESS PROGRAM NAME YES NO FROM TO

ELEMENTARY

HIGH SCHOOL

COLLEGE

POST-GRADUATE

OTHERS

B. PROFESSIONAL ELIGIBILITIES
DATE LICENSE DETAILS

GOVERNMENT LICENSURE / BOARD EXAMS TAKEN RATING TAKEN NUMBER DATE ISSUED EXPIRY DATE

C. PROFESSIONAL TRAININGS, SEMINARS, WORKSHOPS ATTENDED (Please use separate sheets if necessary)

JV-HRD Form-2020-029-Application Form

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Ref. No.
APPLICATION FORM Date

III. EMPLOYMENT RECORD (Please use separate sheets, if necessary)

PERIOD
NAME AND ADDRESS OF COMPANY POSITION LAST SALARY FROM TO REASON FOR LEAVING

Did you previously work with SHIMIZU- FUJITA- TAKENAKA-EEI JOINT VENTURE,? [ ] YES [ ] NO
IF YES, WHICH PROJECTS POSITION DEPARTMENT PERIOD REASON FOR LEAVING

IV. GENERAL INFORMATION

OTHER / SPECIAL SKILLS

INTERNATIONAL LANGUAGES YOU CAN SPEAK AND WRITE LOCAL LANGUAGES / DIALECTS YOU CAN SPEAK AND WRITE

MACHINE(S) / EQUIPMENT(S) YOU CAN OPERATE

HAVE YOU EVER BEEN CONVICTED OF ANY CRIME [ ] YES ( √ ) NO IF YES, GIVE DETAILS

HAVE YOU EVER BEEN AFFLICTED WITH ANY SERIOUS ILLNESS OR MENTAL/PSYCHOLOGICAL DISORDER? [ ] YES [ ( √ N
)O IF YES, GIVE DETAILS

DO YOU HAVE ANY PHYSICAL IMPAIRMENT OR DISABILITY? [ ] YES ( √ ) NO IF YES, GIVE DETAILS

WHAT ARE YOUR FINANCIAL OBLIGATIONS / LIABILITIES? GIVE DETAILS.

ARE YOU WILLING TO WORK ON SUNDAYS AND/OR HOLIDAYS, IF REQURIED? ( √ ) YES [ ] NO

ARE YOU WILLING TO ACCEPT PROVINCIAL ASSIGNEMENT? ( √ ) YES [ ] NO IF YES, WHICH PROVINCE WOULD YOU PREFER?

V. FAMILY BACKGROUND
EDUCATIONAL ATTAINMENT
NAME CIVIL STATUS AGE OCCUPATION ADDRESS

SPOUSE

CHILDREN (EVEN IF SINGLE PARENT)

FATHER

MOTHER

BROTHERS/SISTERS

VI. REFERENCES (Do not include relatives and immediate supervisor)

NO. OF YEARS
NAME COMPLETE ADDRESS AND CONTACT NUMBER OCCUPATION KNOWN

1
2
3

I acknowledge and agree that the above mentioned data and information I have submitted along with this application may be supplied and use by the relevant member(s) of Shimizu-Fujita- Takenaka-EEI Joint Venture to assess and process my application. Upon
successful employment , I understand that Shimizu- Fujita- Takenaka- EEI Joint Venture may disclose the above mentioned data and information to (i) any other member(s) in the Company or third party service provider who provides administrative, data processing,
trainings, insurance services or medical benefits to the Company, (ii) business partners in connection for business related tenders, and (iii) public authorities as may be legally required.
“ I understand that any misrepresentation, falsification or omission of facts of whatever nature required in this application shall be sufficient cause for my dismissal at any time during my employment with Shimizu-Fujita- Takenaka-EEI Joint Venture. I also understand
and fully agree for the company to conduct background investigation as part of the processing of my application.

PRINTED NAME AND SIGNATURE DATE

JV-HRF Form-2020-029 Application Form

Rev.0
JV-HRF Form-2020-029 Application Form
Rev.0