NEW HIRE INFORMATION SHEET

Please complete the form and print clearly. All questions must be answered completely and truthfully; write N/A for items that are not applicable to
you. Failure to do so may result in the refusal or delay of your application.

PART I: PERSONAL INFORMATION

Last Name Given Name Middle Name
Complete Name:

Number-Street/Unit-building Barangay/Village City/Province Zip code

Present Address:

Number-Street/Unit-building Barangay/Village City/Province Zip code

Permanent Address:

Contact numbers:
Email Address:
(Mobile)

Gender: Nationality:
Date of birth:
Civil Status:
(MM/DD/YYYY)
Date of marriage: Place of marriage:
(MM/DD/YYYY) (MM/DD/YYYY)

GOVERNMENT IDENTIFICATION NUMBER

SSS Number: GSIS Number:

Pag-IBIG Number: TIN Number:

Passport Number:
PhilHealth Number:
(Include Valid until)

PART II: CANDIDATE PARTICULARS AND HISTORY

Father's Complete
Mother's Maiden Name:
Name:
Last Name Given Name Middle Name
Maiden Name:
Last Name Given Name Middle Name
Spouse Complete Name:

FAMILY MEMBERS (IMMEDIATE FAMILY - DEPENDENTS / SIBLINGS / PERSON TO NOTIFY IN CASE OF EMERGENCY)
OCCUPATION
BIRTHDATE
NAME RELATIONSHIP CONTACT NUMBER (Employed/Studying,
(mm/dd/yyyy)
Company/Year& Course)

PREVIOUS ADDRESSES FOR THE PAST 10 YEARS

YEARS OF STAY
NUMBER/STREET/VILLAGE/BUILDING CITY/PROVINCE COUNTRY/ZIP CODE
(From - To)

IGT Technologies Philippines, Inc. | Global Resource Organization | New Hire Information Sheet v 1.0_May 2020 | Private and Confidential
 NEW HIRE INFORMATION SHEET

PART III: CHARACTER REFERENCES

FRESH GRADUATES / NO PREVIOUS WORK Provide a minimum of three (3) and a maximum of five (5) names and contact numbers of former On-the-Job Training
EXPERIENCE Supervisors or College Professors
Provide a minimum of five (5) and a maximum of eight (8) names and contact numbers of former Immediate
EXPERIENCED PROFESSIONALS
Supervisors or Managers
NOTE: Please provide valid references only: former professor, supervisor, colleague | NOT fiancé, friend, parents, etc.
NO. NAME RELATIONSHIP OCCUPATION / COMPANY CONTACT NUMBER/S

PART IV: EDUCATIONAL BACKGROUND

NOTE: List information starting from the highest degree taken/obtained.
DATES ATTENDED GRADUATION DATE
SCHOOL / UNIVERSITY ADDRESS COURSE / DEGREE
(FROM - TO) (NA for Undergrad)

PART V: EMPLOYMENT HISTORY

NOTE: List information starting from the most recent employer.
REASON/S FOR
COMPANY NAME AND LOCATION POSITION CONTACT NUMBER/S EMPLOYMENT DATES
LEAVING

PART VI: PROFESSIONAL LICENSES / CERTIFICATIONS / MEMBERSHIPS

NOTE: List information of professional membership starting from the most recent.
DATE JOINED /
INSTITUTION TYPE OF MEMBERSHIP STATUS
OBTAINED MEMBERSHIP

IGT Technologies Philippines, Inc. | Global Resource Organization | New Hire Information Sheet v 1.0_May 2020 | Private and Confidential
 NEW HIRE INFORMATION SHEET

YES NO

Are you agreeable to the background reference and civil litigation?

Have you been previously hired by IGT Technologies Philippines, Inc.?

If yes, when was your hire date? _________________________________________________

Are you related to any past or current employee of IGT Technologies Philippines, Inc.?
If yes, please provide the following details:
Name of Employee: _____________________________________________________________
Department: ___________________________________________________________________

Have you ever been given a memo / verbal warning or any disciplinary action in any company or school?

Have you ever been suspended / terminated or asked to leave?

Do you have any pending court or legal case?

Do you have any cases with your former employer/s?

Do you have any other former or current employer/s aside from those written on your resume?

Can you provide clearance from your former employer?

If not, why not? __________________________________________________________________

Are you confident that all information you disclosed is true and valid?

I declare that the particulars in this application and any sheets attached hereto are true to the best of my knowledge and that I have not
willfully suppressed nor withheld any material fact. I also understand that if after engagements, it is found that I have deliberately made
an untrue declaration on the form, IGT Technologies Philippines, Inc. reserves the right to terminate my services.

Signature over Printed Name Date

IGT Technologies Philippines, Inc. | Global Resource Organization | New Hire Information Sheet v 1.0_May 2020 | Private and Confidential