EMPLOYMENT APPLICATION FORM

This company is compliant to the Data Privacy Act of 2012. All personal data and information you will provide by accomplishing this form shall be used to
process and assess your application for employment. By accomplishing and submitting this form to the HR department, you are hereby granting your consent to
the company to proceed in collecting and processing your personal information in relation to your application for employment.

Date of Application: 05/16/2022

Position Applied: IT QA Tester - Manual Testing
2x2
APPLICATION SOURCE - For HR Use Only:
Colored Photo
Walk-in
X Online Job Portal
Referral by:
Third-Party Agency
Others, please specify

PERSONAL INFORMATION
Last Name First Name Middle Name Nickname/Alias
Chua John Kenneth Mosca Kenneth
Present Residence
Address 1858, Brgy 770, Oro B. Street, Sta Ana Manila
Provincial Address 156, Banaba, Padre Garcia, Batangas
Other residential address for the last seven (7) years, please use additional sheet if needed Inclusive Period of Stay

Mobile Number 1 Mobile Number 2 Landline Number Email Address

0950-323-3576 kennethmosca@gmail.com
Civil
Date of Birth Place of Birth Age Gender Citizenship Religion
Status
02/12/1999 Banaba P.Garcia 23 Male Single Filipino Catholic
FAMILY BACKGROUND
Full Name Age Occupation Company/Business/School
Father Elvie Chua 45 Buy and sell
Mother Margarita Mosca 45 OFW
Sibling 1 Jhan Elrey Chua 21 Kolehiyo ng Lungsod ng Lipa
Sibling 2 John Cedrick Chua 19 Pansol National High School
Sibling 3 Princess Ellaine Chua 17 Pansol National High School
Sibling 4

SPOUSE

Child 1

Child 2

Child 3
In case of emergency, person to notify:
Name Elvie Chua Relation Father Contact Number 0950-651-9404

Address 156, Banaba, Padre Garcia, Batangas

EDUCATION
Finished Degree/Course Year Graduated School Name and Address
Master’s Degree

College Degree BS Computer Engineering 2015-2021 STI College Academic Center Lipa
Vocational Course

High School 2011-2015 Pansol National High School

Elementary 2005-2011 P.Garcia Central Elementary School
Achievements
SKILLS & CERTIFICATIONS
Position-related skills QA-Website Manual Tester
Special Training / Professional
Certification Licenses No.

PREVIOUS EMPLOYMENT RECORD

 Previous employment for the last seven (7) years and start with the most recent employer
Company Thurston Software Solution Inc. Position Title QA Tester

Address Glilialcon Bldg, Bluemintrit, San juan City Tel Nos:

Employment
Nature of Business BPO, Software Solution Services 06/01/2021 – present(rendering)
Period
Immediate Head Sally Tan Designation

Primary Role or Responsibilities Testing website to ensure that the quality and standards meets the client’s expectation.
Reason for Leaving Personal matter and also to find new experience for the career growth.
Company Position Title

Address Tel Nos:

Employment
Nature of Business
Period
Immediate Head Designation

Primary Role or Responsibilities

Reason for Leaving

EMPLOYMENT GAP
Please explain any gaps in employment record
Employment gap duration (month-day-year) Reason for employment gap

N/A
Residence address during the employment gap N/A

Employment gap duration (month-day-year) Reason for employment gap

N/A
Residence address during the employment gap N/A

CHARACTER REFERENCES
Full Name Position Company Contact Details

Kathleen Lustre Supervisor Thurston Software Solution Inc. +63 928 301 103
Ezekiel Gogo QA-1 Thurston Software Solution Inc. 09770920853

VOLUNTARY DISCLOSURE
Have you been discharged from employment because your conduct of work was not satisfactory? No
Have you been civilly, criminally, or administratively charged/arrested/acquitted of a crime? If so, please state the circumstances

No
Have you been hospitalized because of a serious illness? If so, please describe the condition you had.

No
Do you have relatives working at ACC Group (AVLS, Allcard, Allcard Technologies, The Hive-AVLS, First Alpha, Roy-al Congruent)? Please state the
name, positon, company, and your relation to them.
None

Are you currently engaged in any business competing/conflicting with the interest of the above-mentioned companies?

No

Do you have relatives or family members working in any direct and significant competitor of the above-mentioned companies?

None

I hereby authorize the company to verify/investigate all the data and information contained in this form in relation to my application for employment. I hereby
release all parties from any liability arising from such verification/investigation. I understand that any misrepresentation or omission of facts called for is a
cause for termination of my hiring process or employment.

My signature below certifies my consent of allowing the company to use my personal data in processing my application and that I have read, understood, and
agreed to the foregoing and to the best of my knowledge, that all information written by me on this application form are all true and correct.

John Kenneth Chua

Applicant’s Signature Over Printed Name

HR-01-RS-02 Effective Feb. 2020 / Rev. 5