EMPLOYEE APPLICATION FORM

The following information will help us assess your employment opportunity. All portions of this application pertaining to
you must be completed. We appreciate the time you spend in completing this application form.

Position applied for : _______________________________

Recent
Other position(s) you would like to be considered for : ___________________ photograph
3 X 4 cm
Salary expectation : _______________________________
Available starting date : _______________________________

PERSONAL DATA
Full name :  Male  Female
Place / Date of Birth :
Temporary Address :

City : Post code: Telephone :

Permanent Address :

City : Post code: Telephone :

I.D. Card Number : Date of Expiry :
Marital Status : Religion : Blood Group :
Height / Weight : Hobby :
Distinguishing Marks :

EDUCATION AND TRAINING

Name and address of school, University or From To Degree or
Major Course or Study
other Training Institutions. (MM/YY) (MM/YY) Certificate

OTHER ACTIVITIES
Name of Organisation From date To date Status

RECORD OF PREVIOUS EMPLOYMENT

1. Company Name : ____________________________________________ Telephone : _____________________
Address : _________________________________________________ Position : _____________________
Duties : _________________________________________________________________________________
_________________________________________________________________________________
 Nature of Business : _____________________________________
Employment dates : from ____________ to ____________ Supervisor’s Name : ______________________
Salary : _________________________________
Reason for leaving : _________________________________________________________________________

2. Company Name : ____________________________________________ Telephone : _____________________

Address : _________________________________________________ Position : _____________________
Duties : _________________________________________________________________________________
_________________________________________________________________________________
Nature of Business : _____________________________________
Employment dates : from ____________ to ____________ Supervisor’s Name : ______________________
Salary : _________________________________
Reason for leaving : _________________________________________________________________________

3. Company Name : ____________________________________________ Telephone : _____________________

Address : _________________________________________________ Position : _____________________
Duties : _________________________________________________________________________________
_________________________________________________________________________________
Nature of Business : _____________________________________
Employment dates : from ____________ to ____________ Supervisor’s Name : ______________________
Salary : _________________________________
Reason for leaving : _________________________________________________________________________

REFERENCES (Non – Relatives)

1. Name : ______________________ Telp/Mobile: _________________ Company : ______________________
E-Mail : __________________________________________________ Years Known : __________________

2. Name : ______________________ Telp/Mobile: _________________ Company : ______________________

E-Mail : __________________________________________________ Years Known : __________________

3. Name : ______________________ Telp/Mobile: _________________ Company : ______________________

E-Mail : __________________________________________________ Years Known : __________________

LANGUAGE PROFICIENCY
Language skills (Language spoken) :
Language Speaking Reading Writing
English Poor Good Excellent Poor Good Excellent Poor Good Excellent
..................................... Poor Good Excellent Poor Good Excellent Poor Good Excellent
..................................... Poor Good Excellent Poor Good Excellent Poor Good Excellent

FAMILY RECORD
Father’s Name : ______________________________ Age : _____ Occupation : _________________
Mother’s Name : ______________________________ Age : _____ Occupation : _________________
Permanent address : ______________________________________________________________________
City : __________________________ Telephone : _________________
Husband/Wife’s name: ____________________________ Age : _____ Occupation : _________________
First child : __________________________________ Age : _____  Male  Female
Second child : _
_________________________________ Age : _____  Male  Female
Third child : __________________________________ Age : _____  Male  Female

Contact person in case of emergencies : _____________________________ Telephone : _________________

2
 GENERAL INFORMATION
Are you presently employed ?  Yes  No
Have you ever been discharged from employment? If yes, please explain
______________________________________________________________________________________________
______________________________________________________________________________________________

Have you any objection to our contacting your previous employers? Yes  No
Have you had any serious illnesses, injuries or operations within the last five (5) years? If so, please describe
______________________________________________________________________________________________
______________________________________________________________________________________________

Do you have any immediate family members, i.e. husband, wife, parents, child, brother, sister, working within in our
property? Yes No

If yes, who and in which property? (1) _______________________________________________

(2) _______________________________________________

(3) _______________________________________________

Have you ever suffered from any of the following illnesses?

Tuberculosis  Yes  No Heart Disease  Yes  No
Hypertension  Yes  No Diabetes  Yes  No
Venereal Disease  Yes  No Epilepsy  Yes  No
Hepatitis  Yes  No HIV/AIDS Virus  Yes  No

DECLARATION :
I certify that all statements made on this application are true and complete to the best of my knowledge. I understand
that misrepresentation or omission when discovered, will subject me to discharge and I hereby authorize any
investigation relating to my work experience, education, or reputation for the purpose of my application for
employment.

_________________ _________________
Applicant' signature Date

INTERVIEW ASSESSMENT FORM

INTERVIEWER
CRITERIA 1 2 3 4 5
A* B* C* D*
Poor Room for Good Very good Excellent
APPEARANCE improvement
Has difficulty to Satisfactory Good speaker Communicates Clear,
VERBAL SKILLS express with ease convincing,
himself relaxed
Poor Sufficient for Good Very good Excellent
LANGUAGE SKILLS
job
CONTACT Shy and not Shy but has Good, ready Easy, self Outgoing

3
 co-operative potential to co-operate assured, personality,
INTERPERSONAL SKILLS cordial warm and co-
operative
TECHNICAL SKILLS None for job Some Sufficient for Fits job profile Excellent for
applied the job job profile
PROFESSIONAL SKILLS 0 - 6 months 6 months - 1 1 - 3 years 3 - 5 years Over 5 years
year
Shows some, Sufficient, open Good initiative very good as a Excellent,
INITIATIVE
would require for leader definitely a
LEADER ABILITY
orders improvement leader
Apparent, Sufficient for Apparent Very keen and Dynamic,
MOTIVATION tendency for the job desire to willing ambitious, and
routine develop motivated
Frequent Some changes Some Changes with Changes to get
STABILITY changes beyond control planned salary increase promotion and
changes salary increase
Willing to Definite desire Good Very Excellent
CO-OPERATIVE ATTITUDE Co-operate to Co-operate Co-operative Co-operative
attitude attitude
RELIABILITY Willing to prove Written Good written Definitely Excellent,
No police records or record himself references in references in reliable highly
of dishonesty application application recommended

Recommended ( ) Yes ( ) No
Reference check required ( ) Yes ( ) No
Site Inspection ( ) Yes ( ) No
Hired ( ) Yes ( ) No ( ) Put on Hold
Interviewer’s Name A* B* C* D*
& Signature

Human Resources Manager Department Head Executive Assistant Manager General Manager
Date

Overall Summary/
Assessment of
Candidate (if
necessary, continue
on separate page)