To be filled by the interviewer.

(For official use only)

Remarks:

ID Picture
taken within the
last 3 months

DESIRED POSITION (state in order of preference)

PERSONAL INFORMATION
Position Expected Salary Position Expected Salary

Interviewer’s Assessment Code No.: 1. Outstanding 2. Excellent 3. Good 4. Fair 5. Poor

Criteria Code Remarks Code Remarks
General Appearance

Personality

Communication

Working Experience

Qualification

Adaptability

Name (Surname, First Name, Middle Name) Nickname

Birthdate (mm/dd/yy) Birthplace Age Sex

Male

Present Address Zip Code

Permanent Address Zip Code

Telephone No. Mobile No. Email Address

Civil Status Religion Citizenship

SSS No. TIN Philhealth Pagibig

Height (cm) Weight (kg) Blood Type

Contact in case of Emargency Relationship Contact No.

First Interview: Second Interview:

Date: By: Date: By:

Job Title Department

Probationary Salary Starting Date
Salary on Confirmation:

Accepted
Department Head HR Manager General Manager
pected Salary

4. Fair 5. Poor
rks
kname

Female

Zip Code

Zip Code
gibig

act No.

By:

eral Manager
EMPLOYEE APPLICATION
FAMILY BACKGROUND

OTHER INFORMATION
Name (Last, First, MI) Occuaption Contact No. Company
Spouse:
Father:
Mother:
Sibling 1:
Sibling 2:
Sibling 3:
Sibling 4:
Name (Last, First, MI) Birthdate Company / School Position / Course
Child 1:
Child 2:
Child 3:
Child 4:
Title of Seminar / Conference / Workshop Number of Hours
Conducted / Sponsored byOther Information

Professional Licenses
Certification /Registration

Skills
Hobbies
Language / Dialect
Smoking Yes No Alcohol No Occassional Regular

Driver’s License No. Restrictions

Validity Years With own
Driving transport

Continue on separate sheet if necessary

EDUCATIONAL BACKGROUND

WORK EXPERIENCE
Level Year of Attendance School Name Course / Major Scholarship / Academic
From To
Elementary
Secondary

Vocational

College

Graduate
Studies

Are you willing to travel and/or be relocated if the work requires it? If Yes, state why:

Can you work overtime or different shifts if the job requires it?
If Yes, state why:

Do you have any health condition that may affect your work?
If Yes, state why:

Have you joined any labor union before? If Yes, state why:

Have you ever been convicted by any court? If Yes, state why:

Have you ever been separated from service by: Dismissal, Termination, AWOL or similar? If Yes, state why

Have you signed an agreement previously that have a bearing on your employment
(e.g. non-disclosure or non-compete agreement)? If Yes, state why:

How did you know about the employment opportunity?

Date Position Company Salary Reason for

From To
CHARACTER REFERENCES (Name of relatives should not be given)
Name Position Company Contact No.

I certify that information contained in this

information may be grounds for not hirin
point in the future if I am hired. I author
Continue on separate sheet if necessary
 TRAINING AND SEMINARS

Company

Position / Course

Other Information
cassional Regular

Motorcycle
Car

Scholarship / Academic Honors

why:

or similar? If Yes, state why:

ment

Reason for
 Leaving

Contact No.

nformation contained in this application is true and complete. I understand that false
may be grounds for not hiring me or for immediate termination of employment at any
future if I am hired. I authorize the verification of any or all information listed above.

Signature over Printed Name Date

TRAINING AND SEMINARS
PLEASE ANSWER THE QUESTIONS BELOW
Leaving

ication is true and complete. I understand that false

or for immediate termination of employment at any
e verification of any or all information listed above.

e over Printed Name Date