APPLICATION FORM 2X2

PICTURE

*Please do not leave any blank space. Write N/A or none if not applicable.
I .P E R S O N A L I N F O R M A T I O N
Last Name (Apelyido) First Name (Pangalan) Middle Name (Gitnang Apelyido) Extension (Jr., Sr., III, etc.) Nickname (Palayaw)

Javier Julius Zaraspe

Civil Status
Sex Birth Date mm/dd/yy Age
(Katayuang
(Kasarian)
Sibil)
(Petsa ng Kapanganakan) (Edad) 35
Check the applicable item (Lagyan ng lagda sa naangkop) [ ] OWNED [ ] RENTED [ ] OWNED BY PARENT
Present Address (Kasalukuyang Tirahan) Block/Lot/ Number of Street/Subd. Barangay Town/City/ Province

Provincial Address (Permanenteng Tirahan) Block/Lot/ Number of Street/Subd. Barangay Town/City/ Province

Contact No. E-mail Address

Scars or Marks or other

Recent/Current Serious Illness
distinguishing features

Relationship
Person to Contact
in Case of Emergency
Contact No.

Present Address (Kasalukuyang Tirahan) Block/Lot/ Number of Street/Subd. Barangay Town/City/ Province

II . E D U C A T I O N A L I N F O R M A T I O N
PRIMARY/ELEMENTARY SCHOOL (Elementarya)
Inclusive Year School (Paaralan) Address (Lokasyon) Award/s
(Nasasakupang (Tinanggap na Parangal)
Taon)

SECONDARY/HIGH SCHOOL (Sekondarya)

Inclusive Year School (Paaralan) Address (Lokasyon) Award/s
(Nasasakupang (Tinanggap na Parangal)
Taon)

VOCATIONAL SCHOOL (Maikling Kurso)

Inclusive Year School (Paaralan) Address (Lokasyon) Award/s
(Nasasakupang (Tinanggap na Parangal)
Taon)

Course (Kurso) Status (please put check mark) [ ] Graduate [ ] Under graduate _________years

TERTIARY/COLLEGE SCHOOL (Kolehiyo)

Inclusive Year School (Paaralan) Address (Lokasyon) Award/s
(Nasasakupang (Tinanggap na Parangal)
Taon)

Course (Kurso) Status (please put check mark) [ ] Graduate [ ] Under graduate _________years

POST GRADUATE SCHOOL

Inclusive Year School (Paaralan) Address (Lokasyon) Award/s
(Nasasakupang (Tinanggap na Parangal)
Taon)

Course (Kurso) Status (please put check mark) [ ] Graduate [ ] Under graduate _________years

LICENSURE EXAMINATION
Date Taken PRC Exam Taken PRC No. Grade

DRIVER'S LICENSE
Expiration Date License No. Restriction Code

CIVIL SERVICE ELIGIBILITY

License Details
When Where Grade

Professional

Sub-Professional

Not Applicable

__________________________________________
Signature on this page
CORP-HRD-L4-136/Rev.05/Effective Date:03012021 Page 1 of 6 | Application Form
 III . F A M I L Y I N F O R M A T I O N
Check the applicable item (Lagyan ng lagda and naangkop) [ ] SINGLE [ ] MARRIED [ ] OTHERS (specify________________)
SPOUSE'S INFORMATION (Impormasyon ng Asawa)
Last Name (Apelyido) First Name (Pangalan) Middle Name (Gitnang Apelyido) Extension (Jr., Sr., III, etc.)

Birth Date mm/dd/yy Date of Marriage

Age
mm/dd/yy
( Petsa ng Kapanganakan) (Edad)
(Petsa ng Kasal)
Occupation (Trabaho ng Asawa) Company Name (Pangalan ng Kompaniya) Company Address (Address ng Kompaniya)

Children's Full Name (Last Name/First Name/Middle Name) Birth Date mm/dd/yy Age
Pangalan ng mga Anak (Apelyido, Pangalan, Gitnang Apelyido) (Petsa ng Kapanganakan) (Edad)

1
2
3
4
5
FATHER'S INFORMATION (Impormasyon ng Ama)

Last Name (Apelyido) First Name (Pangalan) Middle Name (Gitnang Apelyido) Extension (Jr., Sr., III, etc.)

Birth Date mm/dd/yy Age Occupation

( Petsa ng Kapanganakan) (Edad) (Trabaho)

Company Name Company Address

(Pangalan ng kompaniya) (Address ng Kompaniya)

MOTHER'S INFORMATION (Impormasyon ng Ina)

Last Name (Apelyido) First Name (Pangalan) Middle Name (Gitnang Apelyido) Extension (Jr., Sr., III, etc.)

Birth Date mm/dd/yy Age Occupation

(Petsa ng Kapanganakan) (Edad) (Trabaho)

Company Name Company Address

(Pangalan ng Kompaniya) (Address ng Kompaniya)

SIBLING/S (Impormasyon ng Kapatid)

Siblings Full Name (Last Name/First Name/Middle Name) Birth Date mm/dd/yy Age
Pangalang ng mga Anak (Apelyido, Pangalan, Gitnang Apelyido) (Petsa ng Kapanganakan) (Edad)

1
2
3
4
5
FATHER IN LAW INFORMATION (Impormasyon ng Biyenan na lalaki)
Last Name (Apelyido) First Name (Pangalan) Middle Name (Gitnang Apelyido) Extension (Jr., Sr., III, etc.)

Birth Date mm/dd/yy Age Occupation

( Petsa ng Kapanganakan) (Edad) (Trabaho)

Company Name Company Address

(Pangalang ng kompaniya) (Address ng Kompaniya)

MOTHER IN LAW INFORMATION (Impormasyon ng Biyenan na babae)

Last Name (Apelyido) First Name (Pangalan) Middle Name (Gitnang Apelyido) Extension (Jr., Sr., III, etc.)

Birth Date mm/dd/yy Age Occupation

(Petsa ng Kapanganakan) (Edad) (Trabaho)

Company Name Company Address

(Pangalan ng Kompaniya) (Address ng Kompaniya)

__________________________________________
CORP-HRD-L4-136/Rev.05/Effective Date:03012021 Signature on this page Page 2 of 6 | Application Form
 SIBLING/S IN LAW (Impormasyon ng Kapatid ng Asawa)

*Attach separate sheet if space in insufficient.

Siblings Full Name (Last Name/First Name/Middle Name) Birth Date mm/dd/yy Age
Pangalan ng mga Anak (Apelyido, Pangalan, Gitnang Apelyido) (Petsa ng Kapanganakan) (Edad)

1
2
3
4
5
V I . C H A R A C T E R R E F E R E N C ES
Name (Pangalan) Company (Kompaniya) Contact Number
1
2
3
V.O R G AN I Z A T I O N
List down organization/s or social group/s you are member of. (Ilista ang mga organisasyon o samahang iyong kinabibilangan.)

Name of Organization Address/Tel.No. Membership/Position Held

1
2
3
4
5
VI. W O R K E X P E R I E N C E / S
*Please write your most recent work experience first

Type of
Company Name/Address Position Inclusive Date Reason for Leaving
(Address ng Kompaniya) (Posisyon) Employment (Nasasakupang Araw) (Dahilan ng Pag-alis)
(Direct or Agency)

1 06/15/2021-09/30/2021

2 06/05/2020-06/05/2021

3 06/2/2015-01/05/2018

4 05/17/2011-12/05/2014

5
Have you ever been dismissed or force to resign from position? (please put check mark)
(Ikaw ba ay may pagkakataon na naalis o sapilitang natanggal sa trabaho? Lagyan ng lagda sa naaangkop)
[ ] Yes [ ] No
If yes, please explain
(Kung Oo, paki ditalye)
VII . F O R E I G N C O U N T R I E S V I S I T E D
Date (Petsa) Country Visited (Pangalan ng Bansang napuntahan) Purpose of Visit (Dahilan ng pagbisita)
1
2
3
VIII . O T H E R R E L E V A N T I N F O R M A T I O N
Have you been employed with Asia Brewery Inc or any Sister Company of Asia Brewery?
(Ikaw ba ay nakapagtrabaho na sa Asia Brewery Inc. o kaya sa kasamahang kumpanya ng Asia Brewery Inc.?)

Do you know anyone employed in the Company or from the Sister Companies? If yes, please write his/her name, company, position and department.
(Ikaw ba ay may kakilala na empleyado ng kumpanya o sa iba ang kumpanya ng Asia Brewery Inc.? Kung oo, pakilista ang pangalan, kumpanya, posisyon at departamento. )

Are you related/acquainted to anyone employed with direct competitor?

(Ikaw ba ay may kaugnayan/pamilyar sa sinuman sa kakumpetensyang kumpanya?)

CORP-HRD-L4-136/Rev.05/Effective Date:03012021 Page 3 of 6 | Application Form

 V III. DEROGATORY RECORDS
1. Have you been investigated/arrested, indicted or convicted for any violation of law?
If yes, state the name of court, nature of offense and disposition of case.
(Ikaw ay naimbestigahan/naaresto, nasangkot o nahatulan na sa anumang pag labag sa batas? Kung oo, paki banggit kung anong korte, opensa at hatol sa kaso.)

2. Has any member of your family ever been investigated/arrested, indicted or convicted for any violation of law?
If yes, state the name of court, nature of offense and disposition of case.
(Meron ba sa iyong pamilya ang naimbestigahan/naaresto, nasangkot o nahatulan na sa anumang pag labag sa batas? Kung oo, pakibanggit kung anong korte, opensa
at hatol sa kaso.)

3. Have you been charged in any administrative case? If yes, explain.

(Ikaw ba ay napatawan na ng kahit anong administratibong kaso? Kung oo, ipaliwanag.)

4. Do you use intoxicating liquor? If yes, to what extent.

(Ikaw ba ay umiinom ng nakakalasing na inumin? Kung oo, sa anong lawak.)

5. Do you use narcotics? If yes, to what extent.

(Ikaw ba ay gumagamit ng bawal na gamot? Kung oo, sa anong lawak.)

6. Do you smoke? If yes, to what extent

(Ikaw ba ay naninigarilyo? Kung oo, sa anong lawak.)

7. Have you been arrested or convicted of any criminal offerense? If yes or still pending, Explain.
(Ikaw ba ay naaresto o nahatulan na sa anumang kriminal na opensa? Kung oo o nanatiling dinidinig, ipaliwanag.)

8. Have you been involve in any civil judgements, as a Plaintiff or Dependant? If yes, provide details.
(Ikaw ba ay nasangkot na sa anumang sibil na hatol, bilang nasasakdal o akusado? Kung oo, ibigay ang mga detalye.)

9. Have you been refused entry to any country? If yes, please provide details.
(Ikaw ba ay napigilang pumasok sa ibang bansa? Kung oo, ibigay ang detalye.)

10. Have you been involve in any act of violence? If yes, please provide details.
(Ikaw ba ay nasangkot sa anumang kilos ng karahasan? Kung oo, paki detalye.)

__________________________________________
CORP-HRD-L4-136/Rev.05/Effective Date:03012021 Signature on this page Page 4 of 6 | Application Form
Please sketch your area of residence, identifying with an (X) mark the exact location. Identify major thoroughfare if residence is not located along main street. You may use another sheet
if necessary. (Paki guhit ang lugar ng iyong tirahan, lagyan ng (X) ang eksaktong lokasyon. Ilagay ang mga pangunahing daan kung ang tirahan ay hindi matatagpuan sa malapit sa pangunahing kalye. Maaring
gumamit ng isa pang papel kung kinakailangan.)

SLEX

B
a
t
a
n
g Barangay Tulo
a main road
s
C X
i
t
y

X I . DATA COLLECTION, PROCESSING AND RETENTION/ STORAGE PROVISION

I personally allow the Company to collect, process, retain/store and share my personal information and/or any Government mandated data for the purpose of my
employment. (Pinapayagan ko ang kumpanya na kolektahin, iproseso, panatilihin, itago at ipamahagi ang aking personal na impormasyon at anumang datos na mandato ng gobyerno para sa
aking panunungkulan.)

The answer to the above questions are true to my best knowledge. I voluntarily give the Company the right to carry out whatever investigations it may consider necessary based on the
above answer and I agree to render any assistance required. I agree to work in any location in the Philippines. I also certified that all entry credentials submitted to the company and
answers to the above questions or any statement in the course of interviews which subsequently come to be known as false or willfully omitted be sufficient grounds for the immediate
termination of my employment. (Ang mga sagot sa itaas na mga katanungan ay totoo sa aking kaalaman. Kusang loob kong binibigay sa kumpanya ang karapatan na magsagawa ng
imbestigasyon na nararapat base sa mga sagot at pumapayag ako na tumulong kung kinakailangan. Pumapayag ako na magtrabaho sa anumang lokasyon sa Pilipinas. Pinatutunayan
ko ang lahat ng aking sinumitang kredensyal sa kumpanya at mga sagot sa mga tanong sa itaas o anumang sinabi sa mga panayam na kung malalaman na hindi totoo o tahasang
tinanggal ay magiging sapat na batayan para sa agaran kong pagkatanggal sa trabaho.)

________________________________________________________
Printed Name/Signature
___________________________
CORP-HRD-L4-136/Rev.05/Effective Date:03012021 Date Page 5 of 6 | Application Form
 Declaration
I hereby certify that all information provided in this form is accurate and complete to the best of my knowledge. I understand that any misrepresentation and/or
falsification of any fact may result in cancellation of employment or immediate dismissal.

I recognize that in connection with my job application, I may be subjected to background check and hereby authorize the same.

______________________________________________ _________________________
Signature over Printed Name Date

Letter of Authorization

I hereby authorize ______________________________________ and its background screening partner/ vendor and its associates to verify information provided in
my form for background screening purposes. I Authorize all persons who may have information relevant to this enquiry to disclose it to background screening partner
and its associates, and release all persons concerned from liability on account of such disclosure. I hereby voluntary affix my signature and represent this document
to an original.

I further authorize the procurement of a consumer credit report or other like documents and understand the report may contain information on my background, mode
of living, character. and personal reputation. I further consent to the review and relese of any information from my military records deemed necessary.

I further acknowledge, consent and agree that photocopies of this letter of Authorization may be made and used as if they were original copies.

Signature: _______________________

Full Name: _______________________

Date of Birth: _______________________

Identification No: _______________________

Date: _______________________

CORP-HRD-L4-136/Rev.05/Effective Date:03012021 Page 6 of 6 | Application Form