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Background Check Form

The document is a pre-employment agreement waiver form for an individual, John Ram G. Delfin, being considered for employment at SITEL Philippines. It outlines conditions for employment, including completing medical and background check requirements within 5 days of starting training. It releases SITEL Philippines from liability if these conditions are not met and the individual is terminated. The individual agrees to these terms and understands they are waiving substantial legal rights by signing.

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Ram Ram
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0% found this document useful (0 votes)
182 views6 pages

Background Check Form

The document is a pre-employment agreement waiver form for an individual, John Ram G. Delfin, being considered for employment at SITEL Philippines. It outlines conditions for employment, including completing medical and background check requirements within 5 days of starting training. It releases SITEL Philippines from liability if these conditions are not met and the individual is terminated. The individual agrees to these terms and understands they are waiving substantial legal rights by signing.

Uploaded by

Ram Ram
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PRE-EMPLOYMENT AGREEMENT WAIVER FORM

IN CONSIDERATION of being given the opportunity to be employed by SITEL Philippines, I,


Mr./Ms. ___John Ram G. Delfin________________________________, for myself, my personal
representatives, assigns, heirs, and next of kin:

1. ACKNOWLEDGE and agree that I understand the nature of the job expected of me as a
Customer Service Representative.
2. FULLY UNDERSTAND that as part of the conditions of my employment with SITEL
Philippines, I shall:
(a) Complete my medical exam and submit my valid NBI Clearance within five
(5) days from the start of training.
(b) Complete & submit all primary requirements within five (5) days from the
start of training.
(c) Complete & submit all secondary requirements within five (5) days from
the start of training.
3. AGREE AND WARRANT that failure to meet said conditions may warrant my termination
from SITEL Philippines.
4. HEREBY RELEASE, discharge SITEL Philippines, their administrators, directors, agents,
officers, volunteers and employees, from all liability, claims, demands, losses or
damages on my account caused or allege to be caused in whole or in part by my
negligence to meet the conditions of my pre-employment with the Company.
5. I WILL INDEMNIFY, SAVE AND HOLD HARMLESS SITEL Philippines, from any litigation’s
expenses, attorney fees, loss, liability, damage, or cost which any may incur as a result
of such claim.

I have read this pre-employment agreement, fully understand its terms, understand
that have given up substantial rights by signing it and have signed it freely and without
any inducement or assurance of any nature and intend it be a complete and unconditional
release of all liability to the greatest extent allowed by law and agree that if any portion
of this agreement is held to be invalid, the balance, notwithstanding, shall continue in
full force and effect.

_______________John Ram G. Delfin_________ Date:08:12:2022

Signature over Printed Name of Trainee/Employee Account


LOB
Address: __Area6 Sitio Cabuyao Sauyo Novaliches QC_
Contact No: 09662706493_ Start Date:
BACKGROUND CHECK FORM On-boarding
date:
Company Name: ___________________________ Company Name: ___________________________
Employer Address: _________________________ Employer Address: _________________________
Position/Specialization: _____________________ Position/Specialization: _____________________
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Dates (mm/dd/yy) from: _______ to: __________ Dates (mm/dd/yy) from: _______ to: __________
Immediate Supervisor: ______________________ Immediate Supervisor: ______________________
Contact No.: ______________________________ Contact No.: ______________________________
Best time to call: __________________________ Best time to call: __________________________
Reason for Leaving: ________________________ Reason for Leaving: ________________________
NOTE: Please write LEGIBLY. DO
NOT USE CURSIVE HANDWRITING
Name:
__Delfin_________John Ram____________Gaa____________ _______ _(11-18-1999)
Last First Middle Name Date of Birth (mm-dd-yyyy)

Present Home Address:


_Area 6 Sitio Cabuyao Sauyo Nocaliches Quezon City _____09662706493
Contact Number
No. Street Village Barangay City

Permanent Home Address:

Area 6 Sitio Cabuyao Sauyo Novaliches Quezon City [email protected]_____


No. Street Village Barangay City E-mail Address
EDUCATION| Please make sure that you have supporting documents (TOR/DIPLOMA/COPY OF GRADES/REG. FORMS/STATEMENT OF ACCOUNT)

School Name: ____Capiz State University- Pontevedra Campus_________


School Address: ___Bailan Pontevedra Capiz________________________
Dates (mm/yy): From: ___(07-2018)_________________ to ___(07-2022)_________________
Degree: _Bachelor of Science in Hospitality Management_____________________________________________________
Major (if applicable): ____Food and Beverage______________________________________
Year Graduated: _______2022________________________________________

EMPLOYMENT INFORMATION |Please make sure that you have supporting documents (COE/CLEARANCE FORMS) for every
declared employer
(Please start with the most recent)

Employer 1 Employer 3

Company Name: ___________________________ Company Name: ___________________________

Employer Address: _________________________ Employer Address: _________________________

Position/Specialization: _____________________ Position/Specialization: _____________________

Dates (mm/dd/yy) from: _______ to: __________ Dates (mm/dd/yy) from: _______ to: __________

Immediate Supervisor: ______________________ Immediate Supervisor: ______________________

Contact No.: ______________________________ Contact No.: ______________________________

Best time to call: __________________________ Best time to call: __________________________


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Reason for Leaving: ________________________ Reason for Leaving: ________________________

Employer 2 Employer 4

DECLARATION

I hereby certify that all information provided in this form is accurate and complete to the best of my knowledge. I understand that
any misrepresentation and/or falsification of any fact may result in cancellation of employment or immediate dismissal.

I recognize that in connection with my job application, I may be subjected to a background check and hereby authorize the same.

NOTICE OF CONSENT AND APPROVAL


FOR EMPLOYMENT VERIFICATION

(Please indicate ALL previous/present employers.)

Company Name Contact Information

1.__________________________________________ _________________

2.__________________________________________ _________________

3.__________________________________________ _________________

4.__________________________________________ _________________

5.__________________________________________ _________________

6.__________________________________________ _________________

7.__________________________________________ _________________

8.__________________________________________ _________________

9.__________________________________________ _________________

10.__________________________________________ _________________
Employer Information:

In relation to my application for employment with Sitel Philippines Corporation, I authorize said Company and any of its
third-party background check services provider (particularly: Comprehensive Credit Services, Inc., Link 2 Info – Outsourcing Services
and Vanguard Screening Solutions Inc.) to verify or validate any or all information I have provided or will provide at a later date,
including any or all documents I have submitted or will submit at a later date, related to my employment history and background.
S-1
I am executing this NOTICE OF CONSENT AND APPROVAL, willingly and voluntarily, without
compulsion or intimidation from the Sitel.

WITH MY FULL CONSENT AND AUTHORITY

_________John Ram G. Delfin________


Signature over printed name

________08-12-2022_________
Date

DECLARATION

I hereby certify that all information provided in this form is accurate and complete to the best of my knowledge. I understand that
any misrepresentation and/or falsification of any fact may result in cancellation of employment or immediate dismissal.

I recognize that in connection with my job application, I may be subjected to a background check and hereby authorize the same.

NOTICE OF CONSENT AND APPROVAL

I authorize Sitel Philippines Corporation and any of its third-party background check services provider (particularly:
Comprehensive Credit Services, Inc., Link 2 Info – Outsourcing Services and Vanguard Screening Solutions Inc.) to verify or validate
any or all information I may provide, including any or all documents I may submit, in relation to my application for employment with
said company.

In view of this, I authorize Sitel Philippines Corporation, and any of its third-party background check services provider
(particularly: Comprehensive Credit Services, Inc., Link 2 Info – Outsourcing Services and Vanguard Screening Solutions Inc.) to verify
or validate with the Registrar’s Office, or any related or appropriate office, of
__________________________________________________________ (name of college/institution), any or all information
I have provided or will provide at a later date, including any or all documents I have submitted or will submit at a later date, related
to my educational history and background.

Student Number: _2018-211645_________________

Course Taken: __Hospitality Management______________

Last Year Attended: ___2022______________

I am executing this NOTICE OF CONSENT AND APPROVAL, willingly and voluntarily, without compulsion and intimidation
from Sitel.

WITH MY FULL CONSENT AND AUTHORITY


S-1
______________John Ram Delfin______________
Signature over printed name

_____08-12-20220__________
Date

CHARACTER REFERENCES

NAME: ___John Ram Delfin__


SSS #: ___07-4040222-7________)
TIN #: _______________________________

Please write LEGIBLY. Provide 10 character references (7 minimum). Kindly include their mobile numbers.
Relatives are not allowed in this part. References outside the country are also not allowed. Please do not give Company Trunk
Lines.

Name: ______Cuete Arcosa___________________ Name: _____Christine Golero_________________


Contact Number: 09503224523 Contact Number: 09155351421
Company Name: __N/A__________ Company Name: ___robinsons Place__________
Position: ___Vendor_____________ Position: ___Dental Assistant__________________
Best time to call: ___________________________ Best time to call: ___________________________

Name: ___Steven Bantes Name: ____Armando Borbe__________________


Contact Number: __09053019793__________ Contact Number: ____09353300042 _______
Company Name: __SM City__________________________ Company Name: _JR kool Comp.____________________
Position: ____CRS Representative_______________ Position: ____A/C Technician_________________
Best time to call: ___________________________ Best time to call: ___________________________

Name: ___Lloyd Mark Agris__________________ Name: ___Ma. Mae Tumlos______________________


Contact Number: ____09951878495___ Contact Number: __09065643462____ _________
Company Name: __Youth Organization__________________ Company Name: _Capiz State University_____________
Position: __Executive Director__________________ Position: ___Student Assistant_____________________
Best time to call: ___________________________ Best time to call: ___________________________
Name: __Sherwin Bautista____________________ Name: ____________________________________
Contact Number: 09483556382 Contact Number: ____________________________
Company Name: _Home Credit__________________ Company Name: ____________________________
Position: __CSR________________________________ Position: __________________________________
Best time to call: ___________________________ Best time to call: ___________________________

Name: ____________________________________ Name: ____________________________________


Contact Number: ____________________________ Contact Number: ____________________________
Company Name: ____________________________
Company Name: ____________________________
Position: __________________________________
Position: __________________________________
Best time to call: ___________________________
Best time to call: ___________________________
S-1

John Ram Delfin ___08-12-2022________


Signature above Printed Name Date

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