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Position Applied for : ________________________________________

Source/ Referred by : ________________________________________

EMPLOYEE INFORMATION SHEET

A. PERSONAL INFORMATION
SURNAME FIRST NAME MIDDLE NAME SEX CIVIL STATUS
( ) MALE ( ) SINGLE ( ) WIDOWER/WIDOW
( ) FEMALE ( ) MARRIED ( ) SEPARATED
PRESENT ADDRESS: PROVINCIAL ADDRESS:

Contact #: Contact #:

IF MARRIED; NAME OF SPOUSE: OCCUPATION:

CHILDREN:
NAME/S DATE OF BIRTH AGE

SSS # TIN# PHILHEALTH# HDMF/PAGIBIG # PRC LICENSE # (if applicable)

B. FAMILY INFORMATION
NAME OF FATHER:

LAST NAME FIRST NAME MIDDLE NAME OCCUPATION AGE CONTACT #

NAME OF MOTHER:

LAST NAME FIRST NAME MIDDLE NAME OCCUPATION AGE CONTACT #

BROTHERS / SISTERS
NAME/S OCCUPATION AGE CONTACT #

C. EDUCATIONAL INFORMATION
DEGREE # OF UNITS COMPLETED INCLUSIVE HONORS
EDUCATION NAME OF SCHOOL
EARNED / COURSE TITLE DATES RECEIVED
ELEMENTARY
SECONDARY
COLLEGE
VOCATIONAL
POST GRAD
CIVIL SERVICE ELIGIBILITY/PROFESSIONAL
DATE OF EXAM RATING PLACE OF EXAM
BOARD EXAM PASSED:

WPI-OP-HRAD-1.1F1-A Whiteport, Inc, Unit 1201, 12th Floor The Olive Place, 407 Shaw Boulevard, Brgy. Addition Hills,
Revision: 2 Mandaluyong City 1552, Philippines
Page 1 of 2 Tel: (02) 8535-3293
 D. EMPLOYMENT HISTORY (BEGIN WITH THE LASTEST EMPLOYER)
DATE EMPLOYED NAME AND ADDRESS OF EMPLOYER CONTACT # POSITION SALARY REASON FOR
FROM: LEAVING

TO:

DATE EMPLOYED NAME AND ADDRESS OF EMPLOYER CONTACT # POSITION SALARY REASON FOR
FROM: LEAVING

TO:

DATE EMPLOYED NAME AND ADDRESS OF EMPLOYER CONTACT # POSITION SALARY REASON FOR
FROM: LEAVING

TO:

DATE EMPLOYED NAME AND ADDRESS OF EMPLOYER CONTACT # POSITION SALARY REASON FOR
FROM: LEAVING

TO:

DATE EMPLOYED NAME AND ADDRESS OF EMPLOYER CONTACT # POSITION SALARY REASON FOR
FROM: LEAVING

E. WORK INTEREST INFORMATION

HOW SOON CAN YOU START? ( ) IMMEDIATELY ( ) AT LEAST 15 DAYS ( ) AT LEAST 30 DAYS
ARE YOU WILLING TO BE RELOCATED? ( ) NO ( ) YES
ANY GEOGRAPHIC AREA LIMITATIONS? ( ) NO ( ) YES, WHERE _________________________
ARE YOU WILLING TO BE ASSIGNED ANYWHERE? ( ) NO ( ) YES
OTHER SKILLS: ( ) TYPING ( ) FAX ( ) PHOTOCOPYING MACHINE
COMPUTER LITERACY:( ) WORD ( ) EXCEL ( ) MICROSOFT POWERPOINT ( ) OTHERS: PLS. SPECIFY: _____________
DRIVING SKILLS: ( ) NO ( ) YES ( ) PROF ( ) NON - PROF
EXPECTED SALARY Php ____________________/ month ( ) NEGOTIABLE
F. HEALTH
Pre-existing health condition? ________________________________
Does your pre-existing health condition may affect the performance of the job? _________________

G. TRAININGS & SEMINARS ATTENDED

TITLE VENUE DATE
1.
2.
3.
4.
5.
6.
H. WORK/SCHOOL REFERENCES
NAME ADDRESS OCCUPATION/COMPANY CONTACT #
1.
2.
3.

I UNDERSTAND THAT THE ACCURACY AND COMPLETENESS OF MY STATEMENTS WILL BE RELIED UPON BY WHITEPORT, INC.
IN THE EVENT THAT EMPLOYMENT IS OFFERED AND THAT MISSTATEMENT OR OMISSION CAN CAUSE MY DISMISSAL.

CONFORME: _______________________________________ DATE: _______________________________

Signature over printed name

WPI-OP-ADM-1.1F1-A
Revision: 2
Page 2 of 2