APPLICATION FORM

Date Accomplished:
POSITION APPLIED FOR : Referred by:
Relatives working under Resins Group of Companies (Pls. specify name & company)

PERSONAL (Pls. write first name, middle name and last name)
Name: Nickname:
Current Address: Cel. No.:
Permanent Address: Tel. No.:
Birth place: Pasig City Gender Female Civil Status:
Language/Dialect Speak & Understand: English and Filipino Birthday:
Religion: Christian Height: Weight: Age: Blood Type
SSS No. TIN PAG-IBIG No. Philhealt No.
Name of Father: Age 55 Occupation None
Name of Mother: Age 55 Occupation Midwife
Name of Spouse: Age 36 Occupation Production Staff
Name & Age of Child: Brother/Sister: Occupation:
Name & Age of Child: Brother/Sister: Occupation:
Name & Age of Child: Brother/Sister: Occupation:
Name & Age of Child: Brother/Sister: Occupation:
Name & Age of Child: Brother/Sister: Occupation:
(Please add rows if necessary.) (Please add rows if necessary.)
EDUCATIONAL BACKGROUND
Inclusive dates Honors / Awards
Level School
From To Received
Elementary:
High School:
Senior High School: Strand:
Vocational: Course:
College: Course:
Post-Graduate Studies: Course:
(Please add rows if necessary.)
EMPLOYMENT HISTORY (Start from most recent)
Inclusive dates
Name of Company Position Salary Reason for leaving
From To

(Please add rows if necessary.)

OTHERS Certified Six Sigma White Belt Certification - CSSWB
Government Examinations Passed:
Machines / equipments / vehicles operated:
Computer Operations/Programs Proficient:
Hobbies, interests and special talents:

MEMBERSHIP IN ORGANIZATIONS, RELIGIOUS AFFILIATIONS, etc.

Name of Organization Position Inclusive Date

REFERENCES (Previous employers, pls. exclude relatives)

Name Occupation Address Telephone No.

PERSON TO NOTIFY IN CASE OF EMERGENCY

Name Address Telephone No.

OTHERS:
1. Will you accept job transfers? Co YES NO Contractual employment? YES NO
2. Have you ever been dismissed or asked to resign? YES NO
3. Has any case been filed against you in court? YES NO
4. Have you ever been accused of illegal possession or taking of prohibited drugs? YES NO
5. Have you ever been operated on or seriously ill in the past? YES NO

Acceptable Rate:

I hereby certify that above informations are true and correct and I fully understand that any misrepresentation/
falsification represented herein will be a sufficient ground for my dismissal from service to the company.

By signing below, I am also agreeing to the BeepXtra Philippines Inc Privacy Policy and giving my consent to the collection,
processing, storing and sharing of my personal data in accordance thereto.

Signature Date