DYNATA PHILIPPINES INC EMPLOYMENT

VERIFICATION PLEASE TYPE OR PRINT

_________________CEYNAS________________________JHANNA____________________BUGA
YONG_______________________________
LAST NAME FIRST NAME MIDDLE
NAME (PLEASE INCLUDE Jr., Sr., II, III Etc.)

DATE OF EMPLOYMENT WITH WESTERN WATS, SSI OR DYNATA

BEFORE: ------- NOT A FORMER EMPLOYEE ------------ IF WAS NOT
EMPLOYED BEFORE, PLEASE INDICATE THE WORD ON THE BLANK,
“NOT A FORMER EMPLOYEE”.

ARE YOU CURRENTLY WORKING IN ANOTHER BPO COMPANY? YES or NO :_____ NO _______

ARE YOU AVAILABLE TO WORK FROM 12Midnight - 12Noon? YES or NO:

_______YES____________

ARE YOU 18 YEARS OLD AND ABOVE? YES or NO:________YES___________

ARE YOU INTERESTED IN APPLYING FOR? ENGLISH AGENTS, CHAVACANO AGENTS or MANDARIN
AGENTS: ____ENGLISH__________

I commit that I shall provide true and accurate information needed to process this job offer,
the pre-qualification assessment and the subsequent employment, when applicable, the
failure to do so shall result to the withdrawal of this job offer or the termination of any
process thereafter including employment.

NOTE: We may rescind this offer if we see any misrepresentation of data during application.

_____________________________
SIGNATURE OVER PRINTED NAME
____________
DATE SIGNED