APPLICATION FOR EMPLOYEMENT

Number :

Position Applied for :

 - 2- -

Date :

To Applicant : We deeply appreciate your interest in our organization

and assure you that we are sincerely interested in your
qualifications.

PHOTO 3 x 4
A clear understanding of your background and work
history will help us in orienting you to the position that
best meets your qualifications and may assist us in
possible future development.

PERSONAL DATA FOR OFFICE USE

Full Name :

Present Address :

Permanent Address :

Business Telephone : Home Telp. :

Place & Date of Birth : / /

Place DD MM YY

Sex : Male Female

Marital Status : Single Married

Divorced / Widowed / Separated

Religion : Moslem Christian Others : __________

Children :

No. Name Sex Age

3
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WORK INTEREST FOR OFFICE USE

Position applied for :
Why did you choose this position?

Other position(s) for which you consider to be qualified :

or

Monthly Salary expected (Take Home Pay) :

Work location preferred :

Would you agree to change your profession ? Yes No

State the profession :

Would you agree to work in remote area or developing Yes No

country?

Country preferred :

All Middle East Asia / Pasific

Africa

If your application is considered favorable, on what date you will be available to start
working with this Company ?

EDUCATION BACKGROUND

Name and
Graduated/
School From - To Location of Major Course GPA
Degrees Received
School
Jr. High
Sr. High
Academy
University:
- Bachelor
- Master
- PhD

FOREIGN LANGUAGE SKILLS

Read Write Speak

Language
F G V E F G V E F G V E

English

French

F = Fair G = Good V = Very Good E = Excellent

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TRAINING / COURSE / APPRENTICESHIP RECORDS FOR OFFICE USE

Kind of Training / Course /

From - To Organized by Location
Apprenticeship

EMPLOYEMENT RECORDS

List all present and past employment records, starting with the most recent one.
Use separate block for each employment

1 Period
Company : / / to / /
Type of business :
Starting Position :
Current Position :
Starting Salary :
(Gross / Net) : Salary at Leaving (Gross/Net)
Number of employees supervised (if any)
Brief description of activities (in the last position) :

2 Period
Company : / / to / /
Type of business :
Starting Position :
Current Position :
Starting Salary :
(Gross / Net) : Salary at Leaving (Gross/Net)
Number of employees supervised (if any)
Brief description of activities (in the last position) :
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EMPLOYEMENT RECORDS FOR OFFICE USE

List all present and past employment records, starting with the most recent one.
Use separate block for each employment

3 Period
Company : / / to / /
Type of business :
Starting Position :
Current Position :
Starting Salary :
(Gross / Net) : Salary at Leaving (Gross/Net)
Number of employees supervised (if any)
Brief description of activities (in the last position) :

4 Period
Company : / / to / /
Type of business :
Starting Position :
Current Position :
Starting Salary :
(Gross / Net) : Salary at Leaving (Gross/Net)
Number of employees supervised (if any)
Brief description of activities (in the last position) :

5 Period
Company : / / to / /
Type of business :
Starting Position :
Current Position :
Starting Salary :
(Gross / Net) : Salary at Leaving (Gross/Net)
Number of employees supervised (if any)
Brief description of activities (in the last position) :
Additional Information FOR OFFICE USE
Check where appropriate
No Questions Yes No
Have you ever been convicted in a Court of Law in any country? (If 'Yes',
1 give details in the space below).
Have you ever been detained for medical observation or charged for
2 consumption of drug in any country? (If 'Yes', give details in the space
below).
Have you ever been dismissed or suspended from employment? (If
3 'Yes', give details in the space below).
Have you been or are suffering from any disease/illness/major medical
4 condition/mental disorder or physical impairment?(If 'Yes', give details
in the space below)
For female only -- are you pregnant? (If 'Yes', state how many months in
5 the space below)

6 Are you an un-discharged bankrupt?

Do you have any family members/relatives or friends working in XXX?(If

7 'Yes', give details in the space below)

Have you previously applied for any employment or been employed as

8 employee of PT XXX? (If 'Yes', give details in the space below)

9 Are you willing to travel or be relocated when necessary?

Do you have a family relationship (including parent, sibling, spouse,

child, in-laws or first cousin) with PT XXX's vendor, contractor, business
10 entity or other third party including government official with which PT
XXX does business or is likely to do business? (If 'Yes', give details in
the space below)

Do you or your family (including parents, sibling, spouse, child, in-laws

or first cousin) wihave a financial interest in or shared financial interest
11 with PT XXX's employee, vendor, contractor, business entity or other
third party with which XXX does business or is likely to do business? (If
'Yes', give details in the space below)

Do you have any self business outside of XXX? (If 'Yes', give details in
12 the space below)
**(Space for furnishing details of any item to which the answer is 'Yes' above)
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ACTIVITIES & HOBBIES FOR OFFICE USE

Membership of Professional Association :

Hobbies & Sports :

Social Activities :

PERSONAL REFERENCES (Former Employers or Lectures)

Name :
Occupation :
Address :

Name :
Occupation :
Address :

ADDITIONAL INFORMATION (If any)

The facts stated in this application for employment are true and complete to the best of my knowledge and belief.
I understand that taken information in this application shall be considered sufficient for dismiss from
employement.

Date : Applicant's Signature :

N.B. : Please supply documentary evidence which supports the statements you have made above. Do not,
in any event, submit the original of references, testimonials, certificates or diplomas, unless they have
been obtained for the sole use of this Company.

Photographs and documents are non returnable and shall thereafter be deemed to be the property of
PPD.
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Date :

Name :

According to your education and experiences, what do you expect from your future job in this Company ?

What is your plan in the 3-5 years to come ? How are you going to realize your plan ?

Why should we hire you ? What can you contribute to our company ?

Describe a specific situation in your professional life or studies period, during which you have been appointed to
assume certain responsibilities in leading a team !