Department : Human Resources
Subject :
EMPLOYEE
APPLICATION
The following information will help us
to assess your employment opportunity with XXXXX XXXX XXXXX ( hereinafter called the “Employer” ). All portions of this
application pertaining to you must be completed. We appreciate the time you
spend completing this application form.
|
Other position (s) you would like to be
considered for :
_____________________________
Salary Expectation :
_____________________________
Date available to start :
_____________________________
PERSONAL DATA
Full Name:
™
Male ™ Female
Address :
City : Post
Code: Telephone:
I.D.
Card Number: Marital
Status:
Height / Weight Blood
Group : Distinguishing
Marks:
EDUCATION AND TRAINING
Name and address of school,
university
or other training institutions.
|
From Date
|
To Date
|
Major Course or Study
|
Degree or Certificate
|
RECORD OF PREVIOUS EMPLOYMENT
1. Company
Name: _____________ Telephone: ______________
Address: _____________ Position: ______________
Nature
of Business: _____________________________________
Employment
dates: From _____ To _____ Supervisor’s name :
________________
Wage
/ Salary rate: Start _____ End ____
Reason
for leaving: _____________________
2. Company
Name: ______________ Telephone: ___________________
Address: _____________________ Position: _____________________
Duties:
Nature
of Business:_______________________
Employment
dates: From _____ To _______ Supervisor’s
name :
Wage
/ Salary rate: Start _____ End ______
Reason
for leaving: _______________________
3. Company
Name: ______________ Telephone: ___________________
Address: _____________________ Position: _____________________
Duties:
Nature
of Business:_______________________
Employment
dates: From _____ To _______ Supervisor’s
name :
Wage
/ Salary rate: Start _____ End ______
Reason
for leaving: _______________________
REFERENCES (Non – Relatives )
1. Name:____________Telephone:____________ Occupation : ___________Years known : ________
Address
:__________________________
2. Name:____________Telephone:____________ Occupation : ___________Years known : _________
Address
:__________________________
3. Name:____________Telephone:____________ Occupation : ___________Years known : _________
Address
:__________________________
LANGUAGE PROFICIENCY
Language Skills (Language Spoken) :
I speak fluently I
speak a little
FAMILY RECORD
Father’s Name : Age
: Occupation :
Mother’s Name : Age : Occupation :
Permanent
Address City
: Telephone :
Husband/Wife’s Name Birth Date : Occupation :
First Child : Birth Date : Sex :
Male œ
Female
Second Child : Birth Date : Sex :
Male œ
Female
Third Child : Birth Date : Sex :
Male œ
Female
GENERAL INFORMATION
Are presently employed ? œYes œ
No
Have you ever been discharged from
employment ? If yes, please explain.
Have you any objection to our
contacting your previous employers ? œYes œ No
Have you had any serious illnesses,
injuries or operations within the last five (5) years? If so, please describe.
Do you have any obvious tattoos? œYes œNo
Do you have any immediate family members, i.e. husband, wife, parents, child, brother,
sister, working within the company ? œYes œNo
If yes, who ? (1) (2)
(3)
Have you ever suffered from any of the
following illness?
Tuberculosis œYes œNo Heart Disease œYes œNo
Hypertension œYes œNo Diabetic œYes œNo
Venereal
Disease œYes œNo Epilepsy œYes œNo
Hepatitis œYes œNo HIV/AIDS Virus œYes œNo
DECLARATION:
I certify that all statements made on
this application are true and complete to the best of my knowledge. I
understand that misrepresentation or omission when discovered, will subject me
to discharge and I hereby authorize any investigation relating to my work
experience, education, or reputation for the purpose of my application for
employment.
Applicant' Signature Date
No comments:
Post a Comment