PHARMA NUTRIA N.A., INC. S.V. MORE PHARMA CORPORATION PNSV ASIA CORPORATION
S.V. More Group Corporate Center
#16 Scout Tuason cor. Roces Ave., Quezon City, Metro Manila, Philippines
Telephone Nos.: 373-6240 * 373-6242 * 373-6591
Fax Nos.: 371-1428 * 375-1721 * 371-1649
PERSONNEL INFORMATION SHEET
I. PERSONAL CIRCUMSTANCES:
Position Applied for: ______
Full Name: Nickname:
______
Home Address: Contact No.
______
Provincial Address: Contact No.
______
Date of Birth: Place of Birth: Citizenship: Age: Sex:
______
Religion: Height: Weight: SSS No. Pag-ibig No.:
______
In Case of Emergency Notify: (Relationship) Tin No.: Philhealth No.:
______Address and Contact No.: ______
II. FAMILY:
Status: Marriage Date: Number of Children:
______
- Single Name and Ages of Children: Name and Ages of Children:
______- Married ______
______
Name of Other Dependents: Relationship:
______
______
______
Name of Spouse: Age: Nationality:
______
Education of Spouse: School Where Graduated:
______
Is your spouse employed? Employed as: Monthly Salary:
______
List down father, mother, brothers and sisters:
Name: Age: Occupation: Employer:
______
______
______
______
III. EDUCATION:
Schools Attended: Principal Field of Attended Graduated Honors/Awards
Study/Degree Earned: From To Yes No Received:
______
______
______
______
Designate scholastic standing as top College co-curricular activities participated in:
1/3, middle, lower 1/3: ______
High School: College: ______
______Professional license(s) held: Describe any additional education you have received:
______
______
Have you ever traveled abroad? (Yes/No) Are you presently devoting any time to special study? (Describe fully)
______
Where: When: ______
______State special skills or machines you can operate:
______
______
______
Languages/Dialects: Indicate proficiency in each:
Speak Write Read
______
______
______
______
IV. HOME CIRCUMSTANCES AND FINANCES:
State with whom you live and whether you stay in own home, in boarding house, or renting:
______
Do you contribute to the keep up of any dependents other than your immediate family?”
______
Do you have any dependents who are chronically ill? Do you own any investment in real estate?
______
Do you save money regularly? Do you own bonds?
______
Do you own a car? Make: Model: Year:
______
Do you have a savings account? Do you own stocks?
______
V. MEDICAL HISTORY:
1. Previous Illness/es:
Year Findings / Diagnosis Status / Remarks
______
______
2. Last Medical Check-Up:
When Where Findings / Diagnosis
______
3. History of Hospitalization/s and/or operation/s:
When Where Findings / Diagnosis
______
______
4. State any ailment, illness or physical condition presently bothering you:
______
5. State medicine/s you are currently taking:
______
6. Indicate illness/es you consider yourself more prone or vulnerable to:
______
VI. ORGANIZATION & ACTIVITIES:
Do you belong to and participate in (Identify):
Business organization/s: Social Club/s: Religious Organization/s: ______
______
______
List hobbies in order of preferences:
______
VII. EMPLOYMENT HISTORY:
From: To: Company Name and Address Last Position Salary
Mo. Yr. Mo. Yr.
______
______
______
______
______
VIII. JOB-RELATED AWARDS AND ACHIEVEMENTS:
Nature of Citation: Company: Year:
______
______
______
IX. DETAILS OF EMPLOYMENT EXPERIENCE:
Following the form below, describe your work in each of the last three companies in which you have been employed. Start with the last or present company. Be complete. Be especially careful to give all details of work experiences during your employment. Please use additional sheets if necessary.
1.) Firm: Immediate Supervisor:
______
Reason for leaving:
______
______
Give job titles and description of duties, responsibilities and accomplishments:
______
______
______
2.) Firm: Immediate Supervisor:
______
Reason for leaving:
______
______
Give job titles and description of duties, responsibilities and accomplishments:
______
______
______
3.) Firm: Immediate Supervisor:
______
Reason for leaving:
______
______
Give job titles and description of duties, responsibilities and accomplishments:
______
______
______
X. PREFERENCES AND RELATED MATTERS ABOUT THE COMPANY:
What salary do you desire? Names of employees of this company with whom you
______are acquainted?
What date could you begin work if employed by ______
this company? ______
Have you ever applied work with this Company Names of any relatives/in-laws in this Company’s
before? (Yes/No)______employ?
Who referred you to this Company? ______
______
Why are you applying for a position in this Company? If employed by the Company, do you have marked ______preferences for a particular area? (Yes/No)
______If yes, area preferred and reasons:
______
______
______Second preference:
______
______
XI. GOALS:
At the present cost of living, what income would you need in order to live the way you would like to live?
______
______
______
What plans do you have for the future?
______
______
______
XII. REFERENCES:
Please list three references other than relatives or former employers. Mark with an asterisk those you do not wish us to contact at this time.
Name: Position Company/Company Address Contact No.
______
______
______
May we contact your present employer May we contact your previous employers? (Yes/No) At this time? (Yes/No) ______If yes, which ones?______
I hereby certify that all information contained herein is true and correct to the best of my knowledge.
______
Signature over Printed Name
______
Date