EPS TOPIK UBT 2023 (9TH POINT SYSTEM) SERIAL NO.

- 346

Job Application Form (Update 2023)

EPS-TOPIK ID 0052023C50719065 NID No. 9555727768
Nationality Bangladeshi Full Name ATIQUR RAHMAN
Date of Birth 01/01/1991 Age 25 Years
Passport No. A03153351 PP Issue Date 15/02/2022 PP Expiration Date 14/02/2032 Picture
Taken within 6 Months
Region of origin O Major city Small and medium city O Farm village (Mountain village) O
Fishing Village
Gender  Male  Female Marital Status  Married  Single Divorced
Date of 12/04/2022 Left  Normal Right  Normal
Limbs Arms/hands
Medical Examination  Abnormal  Abnormal
check/
Examination Medical CIVIL SURGEON, Left  Normal Right  Normal
FENI Finger loss Legs/Feet
Center  Abnormal  Abnormal
Height 168 Cm Weight 73Kg Eye vision Left 1.0 Right 1.0 Color Blindness
Mobile (Own) Home Relative’s Phone  Blind  Normal
Phone No.
01976005100 01961250270 01719434163
Fathers/Mothers S/O or M/O: MD ABU JAFOR, BETAGAON, FENI SADAR, AFTAB BIBIR HA- 3900, FENI
Name and Address
Desired Manufacture Sub-cat 1. Rubber & Plastic Duties  Rebar worker  Carpenter
Category  General worker  Welder
Industry egory 2. Metal Industry (Construction only)
3. Tools & Equipment
Desired Salary 20,00,000KRW Skills Test √
Y/ N
Academic  Doctoral Degree  Master’sDegree  Bachelor’s Degree  Associate Degree  High School  Junior High
Background  Elementary Etc. ( )
Name of the Bank DUTCH-BANGLA BANK LIMITED
Applicant’s Branch Name NEW MARKET BRANCH
Email: biplu97@gmail.com
Bank Account Bank Code DBBLBDDH
Account No. 2751570010199
Preferred No ANY CITY HWASEONG INCHEON
1st Choice 2nd Choice
Region Preference
Industry Manufacturing Test Date 29/11/2021
EPS-TOPIK Readi 40 40 Total 80 Average 40
Score Listening
ng Score Score
Vocational
Level Major
School
Korean  Excellent  Good  Poor English  Excellent  Good  Poor
Language
Proficiency Other
HINDI  Excellent  Good  Poor
Language
1
Licenses 2
3
Industry Term of
Country Sub-Category Duties (construction only )
Category Employment
Work  Rebar worker  Carpenter
1 MM/YY  General worker  Welder
Experience any
 Rebar worker  Carpenter
country 2 MM/YY  General worker  Welder
 Rebar worker  Carpenter
3 MM/YY  General worker  Welder
Work Experience in Korea  Yes  No Foreigner’s Registration Number
Name of School/ College/
: MIRPUR GOVT. HIGH SCHOOL.
University
Location of School/ College/ :
FENI SADAR, BANGLADESH.
University (city/province/country)
: (a) Full Name in English : MD. JAHIRUL ISLAM
(b) Country of Residence : PATUAKHALI, BANGLADESH.
Emergency Contact Information (c) Telephone No. : 01719434163
(d) Relationship to you : BROTHER
Have you ever used any other names :  No  Yes → If ‘Yes’ please provide details
to enter or depart Korea? (Family Name: , Given Names: )
Is the invitee a citizen of more than :  No  Yes → If ‘Yes’ please provide details
one country? (Detailed information: )
Does the invitee have any other :  No  Yes → If ‘Yes’ please provide details
valid passport? (a) Passport Type : Diplomatic[ ] Official [ ] Regular [ ] Other [ ]
(b) Passport No. : (c) Country of Passport :
(d) Date of Expiry :
Has the invitee travelled to :  No  Yes → If ‘Yes’ please provide details
Korea in the last 5 years? ( ) times, Purpose of Recent Visit ( )

Has the invitee travelled outside  No  Yes → If ‘Yes’ please provide details
his/her country of residence, Period of Stay
excluding to Korea, in the last 5 Name of Country Purpose of Visit
(yyyy/mm/dd)~ (yyyy/mm/dd)
year

Personal information of your ※ If you are ‘married’, please provide details of your spouse in English.
spouse ㆍ Family Name : KHALEDA AKTER
ㆍ Given Name :
ㆍ Date of Birth (yyyy/mm/dd) : 1985/12/13
ㆍ Nationality : BANGLADESHI
ㆍ Residential Address : BETAGAON, FENI SADAR, AFTAB BIBIR HA- 3900, FENI

ㆍ Contact No. : 01961250270

Do you have children?  No
 Yes →ㆍ Number of children [ ]
Name of Korean Language : EKUSH LANGUAGE AND IT INSTITUTE
Learning Center
Korean Language Learning : 131/B Kay Khosru Bhabon (1st Floor), Jahanara Garden, Green Road, Farmgate, Dhaka.
Center Address
Contact Number : 01713 290 275 Email : ekushinfo@gmail.com
Korean Language Learning Cost : 15,000/-

 I attest to the fact that the above information is true and valid. I understand that I will be held responsible for any damages or
problem caused by inaccuracy or invalidity of the information.
 Furthermore, I hereby give my consent for the relevant authorities involved in the management and coordination of the EPS
to disclose and use the information for the purpose of supporting employment arrangement for employers, entry and sojourn
management, return support and prevention of the illegal stay of workers (Private information retention and usage period: the
information will be destroyed upon the completion of the intended tasks).
 Submission of this application & Entry in the Job Roster does not guarantee your job in Korea (PvKzwii
Av‡e`b Ges Re †iv÷v‡I bvg AšÍfz©w³ `wÿb †Kvwiqv Avcbvi PvKzwii wbðqZv enb K‡ibv)

Signature :
Date :