Application for Employment

DATE:

POSITION APPLIED FOR:

DESIRED SALARY:

SSS No.: PAG-IBIG No.:

PHILHEALTH No.: TIN No.:

I. PERSONAL AND FAMILY BACKGROUND

Name: Birthdate:

Age: Birthplace

Address: Email Address:

Contact Number: Religion:

Citizenship: Blood type:

Height (ft/in): Weight (kg):

Civil Status: Name of Spouse:

Father’s Name: Mother’s Name:

II. EMPLOYMENT HISTORY

Show your last three (3) employment and other related experiences (i.e. volunteer experiences or on-the-job training)

*Company Name: From (Mo/Yr): Position:

Address: To (Mo/Yr): Main Duties:

Supervisor’s Name: Starting Salary:

FM-IMS-GR-EAF-047/rev. 0/Aug. 30, 2022

 Contact Number: Final Salary: Reason for Leaving:

*Company Name: From (Mo/Yr): Position:

Address: To (Mo/Yr): Main Duties:

Supervisor’s Name: Starting Salary:

Contact Number: Final Salary: Reason for Leaving:

*Company Name: From (Mo/Yr): Position:

Address: To (Mo/Yr): Main Duties:

Supervisor’s Name: Starting Salary:

Contact Number: Final Salary: Reason for Leaving:

III. EDUCATIONAL BACKGROUND

Highest Educational Attainment:

Name of School: Course Taken: Year Attended:

IV. GOVERNMENT EXAMINATIONS:

FM-IMS-GR-EAF-047/rev. 0/Aug. 30, 2022

 Examination Date Taken Location Rating License No.

V. GENERAL INFORMATION:

Are you an affiliate/member of any organization, society, club whether business, school or social? [ ] Yes [ ] No
If yes give particulars __________________________________________________________________________________________

Are you referred by a CMi employee? [ ] Yes [ ] No

If yes, by who? _________________________________________________________________________________________________

Have you previously applied with our Company? [ ] Yes [ ] No

Have you been previously employed with our Company? [ ] Yes [ ] No

How soon are you available for employment?

VI. PERSONAL REFERENCES:

Name Occupation Contact Number

IN CASE OF EMERGENCY:

Person to notify: ______________________________________________________________________

Relationship:__________________________________________________________________________
Contact Number:______________________________________________________________________

FM-IMS-GR-EAF-047/rev. 0/Aug. 30, 2022

I hereby certify that all statements made in this application, to the best of my knowledge are TRUE. I understand
that any false information will be sufficient cause for termination at any time if employed. I also authorized the
Company to check/verify any information contained in this application.

Date:_____________________ Signature over Printed Name:____________________________________

FM-IMS-GR-EAF-047/rev. 0/Aug. 30, 2022