EELHI Application Form
EELHI Application Form
APPLICANT CODE:
LAST NAME FIRST NAME MIDDLE NAME MAIDEN NAME
CIVIL
STATUS: SINGLE MARRIED DIVORCED SEPARATED WIDOWED
HEIGHT WEIGHT BLOOD TYPE NATURE AND DATE OF MOST RECENT ILLNESS
ORGANIZATIONAL AFFILIATIONS
ORGANIZATION/CLUB INCLUSIVE DATE (month/year) POSITION HELD
EMPLOYMENT RECORD (start with last or present employer)
INCLUSIVE DATE LAST POSITION BASIC SALARY REASON FOR
NAME OF EMPLOYER EMAIL ADDRESS CONTACT NO. (month & year) HELD LEAVING
FROM:
TO:
FROM:
TO:
FROM:
TO:
FROM:
TO:
FROM:
TO:
BUSINESS MACHINES OPERATED: SPECIAL SKILLS POSSESSED: HOBBIES/INTERESTS:
FAMILY DATA
NAME ADDRESS OCCUPATION
FATHER
MOTHER
SPOUSE
SPOUSE'S DATE OF BIRTH: SPOUSE'S EMPLOYER:
INFORMATION ON CHILDREN (Please use the back page when needed)
NAME DATE OF BIRTH AGE SCHOOL/ADDRESS
1)
2)
3)
4)
INFORMATION ON BROTHERS AND SISTERS (Please use the back page when needed)
NAME DATE OF BIRTH AGE SCHOOL/ADDRESS
1)
2)
3)
4)
PRE-EMPLOYMENT STATEMENT
VERY IMPORTANT!!!
I EXPRESSLY GIVE MY CONSENT TO THE COMPANY AND/OR ANY OF ITS AUTHORIZED PERSONS TO COLLECT, RECORD, PROCESS, ORGANIZE, UPDATE
AND USE MY“PERSONAL INFORMATION” AND “SENSITIVE PERSONAL INFORMATION”, AS DEFINED UNDER THE DATA PRIVACY ACT OF 2012 AND AS
OBTAINED HEREIN, FOR THE FOLLOWING PURPOSES: (1) TO COMPLY WITH ANY REGULATION REQUIRED BY LAW, (2) TO ASSESS AND EVALUATE MY
SUITABILITY FOR EMPLOYMENT IN ANY CURRENT OR PROSPECTIVE POSITION WITHIN THE COMPANY, AND (3) TO VERIFY THE ACCURACY OF THE
“PERSONAL INFORMATION” AND “SENSITIVE PERSONAL INFORMATION” IN RELATION TO MY JOB APPLICATION.
FOR THESE PURPOSES, I HEREBY, AUTHORIZED THE COMPANY AND/OR ANY OF ITS AFFILIATES OR AUTHORIZED PERSONS TO INVESTIGATE, OR TO
HAVE INVESTIGATED IN ITS/THEIR BEHALF, ALL FACTS CONCERNING MY SKILLS, HABITS, CHARACTER BACKGROUND AND SUCH OTHER
INFORMATION AS MAY BE PERTINENT TO MY JOB APPLICATION.
I UNDERSTAND THAT ANY MISREPRESENTATION 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 EMPLOYMENT WITH THIS COMPANY OR ANY OF ITS
AFFILIATES.