SAMSUNG ELECTRO-MECHANICS PHILIPPINES CORPORATION
BLK. 5 CALAMBA PREMIERE INTERNATIONAL PARK,
Latest Photo
BRGY. BATINO, CALAMBA CITY, LAGUNA
Tel. No. (049) 508-8300 / Fax. No. (049) 508-8450
APPLICATION FOR EMPLOYMENT Date Applied:
Personal Data
Job Preference: 1. 2. 3.
How soon can you start? Referred Applicant? : Referred by: Salary Desired
Yes No
Last Name First Name Middle Name Nickname
Present Address / Telephone No. Zip Code ( ) Permanent Address / Telephone No. Zip Code ( )
Provincial Address / Telephone No. Zip Code ( ) Cellphone Number
Family Background
Name Relationship Birthdate Age/Sex Occupation Position Name of Company / Address
Spouse’s Complete Name Date of Marriage Date of Birth
Address Occupation / Position / Company Educational Attainment
Name Birthdate Age/Sex Educational Attainment
Children
Educational Background
Name of School & Branch Inclusive Years Date Graduated Gen. Average Awards/Honors Received
Elementary
High School
Voc. School
College
Course
Masteral
Post Graduate
Study
Employment Record (Start with the present or latest)
Inclusive date
Company Name / Address / Tel No. Position Salary Reason for Leaving
From To
Professional Membership / Organizations
Name of Organization Inclusive Dates Position Held
Training / Seminar Attended
Title / Topic Conducted by Inclusive Dates
Other Information / Skills
Spoken Language (in order of proficiency) Written Language (in order of proficiency)
1) 1)
2) 2)
3) 3)
Office Machines / Equipment you can operate Computer Skills
Indicate skill rating (E= Excellent, G=Good, F=Fair) MS Excel MS Access
Fax: Others (pls specify):__________________________ MS Word Database
PC __ _______________________ MS Powerpoint Others, pls. specify
Electric Typewriter
Hobbies/ Talents / Other Interests:
Were there any civil/administrative case you were involved in/ pending against you? Yes No
Details:
Government Exams / Licensure Taken
Field Date Rating License No.
Have you suffered from any serious illnesses, hospitalization or accidents in the past five (5) years? Yes No
Details:
Person to notify in case of emergency: Relation: Address & Telephone No.:
Friends / Relatives Employed at Samsung
Name Relationship Position Department Confirmation
Character references (not related to you)
Name Company Name & Address Position Telephone / Cellphone No.
Short statements that would described your attitude as a person and as an employee
I understand that any misinterpretation or falsification, or any omission of facts of whatever nature required by this application shall be considered
sufficient cause for dismissal at any time during my employment in the Company. In addition, I am allowing or authorizing the company to check all
the information that I’ve written in this application form. If employed, I promise to undertake and abide by all the rules, regulations set and prescribe
by this company, including transfers and assignments to other locations the company deems best.
SEMPHIL as employer, process the personal information and sensitive personal information you share in course of your application. Processing
includes, but is not limited to, collection, recording, storage, updating or modification, retrieval, consolation, use, consolidation, blocking, erasure or
destruction of information. By affixing your signature below, you confirm that you have read and understood this Personal Date Consent and that
you consent to SEMPHIL collecting, processing and disclosing your personal data as written above.
I have declared true information and read the data consent in good order.
Applicant’s Signature
SSS No.
Pag-IBIG No.
TIN No.
Res. Cert No.
Issued at
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