Laguna State Polytechnic University

Main Campus, Santa Cruz, Laguna

Office of the Alumni Affairs and Placement Services
Email add.: lspujobplacement@yahoo.com
Tel. #: (049) 808 4942
Cellphone #: 0928 488 - 3803
I. ALUMNI PROFILE

Printed Name: ______________________________________________________________

LAST NAME FIRST NAME M.I.
Contact No: ________________________________________________________________

Age: ___________ Address: _________________________________________

Gender:
Male: _________ Female: ________

Civil Status:
Single: ________ Married: ________ Widow/Widower: __________

Course Taken: __________ Year Graduated: ________

Major: _______________

II. EMPLOYMENT BACKGROUND:

Company Name/School:
1. _____________________________ Year Employed: ___________
2. _____________________________ Year Employed: ___________
3. _____________________________ Year Employed: ___________
4. _____________________________ Year Employed: ___________

Company Address:
1. _____________________________
2. _____________________________
3. _____________________________
_____________________________
Position: Status:
Contractual: ____________
Provisionary: ____________
Permanent: ____________
Nature of work:

Self Employed: (Pls. Check id applies to you) ____________

(Signature over Printed Name)

____
Date Accomplished