INSTRUCTIONS

Please answer each question clearly and

completely. INCOMPLETE APPLICATION WILL
NOT BE PROCESSED. Read carefully and follow
all directions. Any omissions, misrepresentation EMPLOYMENT APPLICATION
discovered in the future could be ground for Recent
termination. IF YOU DO DRUGS. DON'T BOTHER Photo
TO APPLY, WE TEST FOR DRUGS USAGE

Position Applied: Position Code:

SERVICE ENGINEER

1. Family Name First Name Middle Name

SALONGA GLENN PALISOC
2. Date of Birth 3. Place of Birth 4. Present Nationality 5. Sex

JULY 30, 2022 SAN CARLOS CITY, PANGASINAN FILIPINO MALE

6. Marital Status 7. Religion

/ Single O Married O Separated O Widow O Divorced CHRISTIAN
8. Telephone No. 9. Fax No. 10. Passport/Identity Card
Mobile Phone No. 09193785858
Others: please provide the following
SSS number PAG-IBIG number
TIN number PhilHealth number
Res. Cert.
11. Current Address

O Own O Rent O Board / Living w/ Parents/Relatives

12. Provincial Address

196 NELINTAP, SAN CARLOS CITY, PANGASINAN

13. Do you have any dependents? / Yes O No If 'YES' give particulars below
Name Age Relationship Name Age Relationship
JEANETTE P. SALONGA 53 MOTHER

14. Knowledge of Languages

LANGUAGE Understand Speak Write Read

........................................... ENGLISH ......................./ ......................./ ......................./ ......................./

........................................... FILIPINO ......................./ ......................./ ......................./ ......................./
...................................... PANGASINAN ......................./ ......................./ ......................./ ......................./
15. For Clerical Grades only- Indicate speed in words per minutes List of any office machines or equipment you can use

Spouse Name: N/A Date of Birth: Occupation: (if any)

16. Other Skills

17. Education: Give full details

Name and Place Years attended Degree & Academic Main Course of Study
From To
Elementary BOLINGIT ELEMENTARY SCHOOL 2004 2006

High School SPEAKER EUGENIO PEREZ 2010 2014

AGRICULTURAL SCHOOL
College UNIVERSIDAD DE DAGUPAN 2014 2019 BACHELOR OF SCIENCE IN
ELECTRONICS AND
COMMUNICATIONS ENGINEERING
Master Degree N/A

School or Formal training or education N/A

Name and Place Years Attended High Class Complete Certificates or Diplomas obtained
From To

...................................................... ............... ............. ...................................................... ..............................................................................

................................................... ............ ............. ................................................... ...........................................................................
.
EMPLOYMENT RECORD. Start with present post and list in reverse order every employment you have had. If you need more space, attach additional pages of the same
size.
From To Salary per month Exact Title of Post
25,000
SAFETY OFFICER III
Month Year Month Year Supervisor's Title Type of Business

JANUARY 2022 PRESENTT PRESENT PROJECT MANAGER BUILDING CONSTRUCTION CONSULTANT

Name of Employer Name of Supervisor

LUCRUM ENTERPRISES CORPORATION
Address of the Employer Number and kind of employees supervised by you
CULMAT BUILDING, E. RODRIGUEZ SR. AVENUE, QUEZON CITY
10 – CONSRUCTION WORKERS
Tel. No. 02-0570-5678
Reason for Leaving

Description of your Duties

ENSURE THE SAFETY OF THE WORKERS

From To Salary per month Exact Title of Post

Month Year Month Year Supervisor's Title Type of Business

18. AFFILIATION: Membership in clubs, societies and activities in civic, public or international affairs, fraternities, union membership etc.
REFERENCES. List three persons not related to you who are familiar with your character and qualifications. Do not repeat names of supervisor s listed previously.
Full Name Business or Organization Full Address and Telephone

................................................................ ................................................................. ........................................................................

.............................................................. ............................................................. .....................................................................
19. FOR ALL APPLICANTS
If employed by the company, you must give at least 30 days advance notice to the company before resigning and taking other job otherwise, no clearance will
be issued to you and any amount due to you not exceeding one month salary will be held to compensate cost of replacement training. The applicant agrees not to be
employed or connected directly or indirectly within two (2) years from separation from the company either as an employee, consultant, adviser, officer, owner,
share/stockholder or partner with any persons, companies, corporations or entities whose products and or services are directly or indirectly competing with the
company. The applicant further agrees to keep material information, knowledge gained, sales or technical know how and trade secrets (i.e. List of customers, price list,
etc.) strictly confidential within the same period. Lastly, the applicant agrees to compensate the company in terms of monetary damages commensurate to the loss of
sales revenue for any violation of these agreement.

/ Accepted O Not Accepted Signature ________________________

20. Have you ever been arrested, indicted or summoned into court as a defendant in a criminal proceeding or convicted final or imprisoned for the violation of any law
(excluding minor traffic violation)?

O Yes / No If 'YES' give full particulars of each case in an attached statement

21. Drug Testing

In support of our country's and company's program of a drug free environment I am waiving my right of refusal and agrees to voluntarily undertake drug test at
any time the company may so desire. This waiver is part of the condition of the company's decision to accept my employment.

/ Agree O Disagree Signature _______________________

22. For All Applicant
If you are not meeting your performance target or job assigned after the performance eveluation will you resign voluntarily?

O Yes / No Why? I BELIEVE THAT THERE IS ALWAYS A ROOM FOR IMPROVEMENT AND I KNOW THAT THERE’S A LOT TO LEARN.

23. Do you have any relative or friends in this company or other companies that our competitors? Any misrepresentation or non-disclosure by the applicant if
discovered later is ground for termination.

O Yes / No If 'YES' state name, relationship and organization

__________________________________________________

NOTE: It is strictly prohibited as a part of company policy to hire both spouses. In case you are hired and got married to another employee regardless of position,
one of you must resign.

/ I Agree (signature)
24. For Sales Applicant Only Monthly Sales
Products Handled Brand Maximum Average Commission/Income from Sales

25. In which of the above product do you excel in selling? How much was your total income last year?

26. Are you physically able and willing to travel? O Yes O No

Are you willing to accept provincial assignment if needed? O Yes O No
27. Have you ever been discharged or forced to resign for any position?
O Yes O No If 'YES' give details
28. Person to be notified in case of emergency:
Name: JEANETTE P. SALONGA Tel. No.
Address: 196 NELINTAP, SAN CARLOS CITY, PANGASINAN
REFERENCES. List three persons not related to you who are familiar with your character and qualifications. Do not repeat names of supervisor s listed previously.
Full Name Business or Organization Full Address and Telephone
29. Do you have any pending application for immigrant visa?
O Yes / No If 'YES' to what country?
30. Driving Skills: Do you know how to drive the following vehicles?
/ Motorcycle O Van (more than 4,500kgs) O Car O others, pls specify
31. Amount of insurance you carry Average income/month last year (Salary, commission etc.)
PhP 25,000 PHP

32. Desired Minimum Salary : 30,000

33. I certify that the statement made by me in answer to the foregoing are true, complete and correct in all respect to the best of my knowledge and belief. I understand
that any misrepresentation or material omission made in this application will be ground for termination.
Date: .................................... Signature: ..........................................