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ACZENTA International GmbH Badenerstrasse 580 8048 Zurich - Switzerland Tel +4 44 !4" !0 0 #a$ +4 44 !4" !

0 8 %-mail contact&aczenta'com (eb www'aczenta'com

Inquiries to the Application

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Family Name: First Name: *osition+s, a--lied. /ate o0 Birth. 6ationalit2+s,. Home Tele-hone number. 8ellular -hone. Tele-hone at wor:. S:2-e I/ ;ddress. <a2 we contact 2ou at wor:= Best time to call 2ou at home= (hat date are 2ou a@ailable 0or wor:= /o 2ou need to )i@e a notice -eriod= ;re 2ou willin) to relocate abroad= 6o 5 o'clock 1anuar2 3 6o Ansatis0ied 0or salar2 >es? on sin)le status onl2' >es? I want to relocate e$clusi@el2 with m2 0amil2' Both? sin)le or married status acce-table' 6o' ;re 2ou le)all2 eli)ible 0or em-lo2ment in the 0ollowin) countries= %uro-ean Anion Anited States Bther.

Stoica Gheor)he Senior Tool -usher 1anuar2 3 4th 3 54 7omanian 0040 "44584 !! 0040 945"0!885

>es? best time to call ;< *< h 3 "0 4



7eason 0or lea@in) 2our current em-lo2er=

Proof of Citizenship or immigration status will e re!uire" prior to emplo#ment

T2-e o0 em-lo2ment desired. ;nnual gross wa)e earned +bene0its e$cl',. ;nnual net wa)e earned. Indicate additional bene0its to the wa)e.

#ull Time


*roDect related
$n"icate the gross and net wage an" currenc# without o%ertime an" other %aria le enefits&


*re0erred net remuneration. Indicate additional reEuested bene0its. 7emar:s 3 additional in0ormation.

AS/ 55?000 In assessin) o0 the com-an2

$n"icate the net wage per annum an" currenc# without %aria le income or enefits&


ACZENTA International GmbH Badenerstrasse 580 8048 Zurich - Switzerland Tel +4 44 !4" !0 0 #a$ +4 44 !4" !0 8 %-mail contact&aczenta'com (eb www'aczenta'com

Important notice:
The in0ormation that 2ou -ro@ide on this 0orm is @er2 im-ortant to us as it enables us to assess 2our a--lication and in0ormation with the Dob o--ortunities' ;n2 -ersonal in0ormation 2ou submitted to us on this 0orm and in the accom-an2in) -a-ers will be treated in accordance with the Swiss #ederal ;ct on /ata *rotection in 0orce and stored in our database' It will onl2 be used 0or the -ur-oses o0 considerin) 2ou 0or a Dob o--ortunit2' >ou ma2 either return this Euestionnaire b2 e-mail? or alternati@el2 2ou can 0a$ it to +41 44 4! " 1# or -rint it o00 and mail it to our o00ice'

I declare that m2 answers to the 0ore)oin) Euestions are true and correct without an2 conseEuential omissions o0 an2 :ind whatsoe@er'

I ;)ree

I do not a)ree

/ate. 053 "3 !


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