Information Data Sheet - 2012
Information Data Sheet - 2012
Information Data Sheet - 2012
PERSONAL DATA
Position Applied: 1st Choice : ________________________ 2nd Choice: ________________________ Surname: Present Address: Provincial Address/Permanent Address: Office Address: Civil Status: Height: Place of Birth: Weight: Date of Birth: Citizenship: TIN # Date of Birth Address Date of Birth Occupation Mother's Name Occupation Name Children Address Address Date of Birth Address Date of Birth Age: Sex: Salary Desired: 3rd Choice : ________________________ 4th Choice: ________________________ First Name: Middle Name: E-mail Address: Phone/Mobile No.: Phone No.: Phone No.: Religion: SSS # Philhealth# Place of Birth Employer Place of Birth Employer Place of Birth Employer Place of Birth
Address
Date of Birth
Place of Birth
EDUCATIONAL BACKGROUND
Name of School Elementary Secondary College Graduate Other Studies Degree Years Attended From To Honors
WORK EXPERIENCE/S
Name & Address of Company (Previous to Present) Inclusive Period From To Salary Position Reason for Leaving
Government Exams/Taken:
Rating
version:2012
CAREER
What type of work are you best qualfied? What type of work do you like eventually? The management reserves the right to transfer to any Group/Department/Unit. What type of Group/Department/Unit would you prefer?
OTHER INFORMATIONS
Have you been discharged/terminated/forced to resign from previous employment? Yes ( ) No ( ) If Yes, please state the reason: Have you been charged, accused, indicted or tried for violation of any law, ordinances or regulations, etc.? ( ) Yes ( ) No. If Yes, please give details. Are you suffering or have you suffered major ailments during the last five years? ( ) Yes ( ) No. Please describe ailments, if any: Describe any physical defects or disabilities you may have: Have you previously applied with SHFC? ( ) Yes ( ) No If Yes, When? Where? Are you related to employee(s)/worker(s) by consanguinity or affinity or (in the absence of both) friend(s) who has been employed/working in SHFC or (in the absence of both) other government agencies? Name Division Group Relation
Have you been a member of any worker(s) organization or union? ( ) Yes ( ) No. If Yes, please specify: Whom to notify in case of emergency: Name, Relation, Address, Tel. No.
Pls. draw and illustrate your present residence indicating important landmarks for easy reference.
ACKNOWLEDGEMENT
I hereby confirm that the mere filing of this form does not obligate the SHFC to hire my services. I understand that if I am hired, this application and all I have stated herein shall form part of my 201 file. If required, I am willing to submit myself for Mental Alertness Test and IQ Test as well as taking and passing the Psychological and Medical examinations in the manner and form provided by the SHFC as condition to my hiring. I agree to abide by the SHFC's rules and regulations, its policies, and I further agree to work overtime or to be transferred to other Unit/Department/Group and other locations when required by the SHFC. I hereby certify to the truth and correctness of the above information and data. I relieve SHFC from any liabilities, resulting from verifying the above information and I understand that any false or fraudulent information made in this application form shall constitute sufficient ground for disapproval of my application or if hired, for termination without need of prior notice.
Applicant's Signature
Remarks:
INTERVIEW RESULTS
Admin. Department:
Interviewed by and Date: ________
Requisitioning Department:
Interviewed by and Date: ________
Requisitioning Group:
Interviewed by and Date: ______
President:
Date: ____________
Period of Hiring: ____________ Salary: ___________________ Allowance : _______________ APPROVED BY: ____________________