HR Form No.
02 – Employment Application Form
EMPLOYMENT APPLICATION FORM
Date Accomplished:
Position Applied for:
Family Name First Name Middle Name Nickname Photo
Age Date of Birth Place of Birth Gender at birth Height Weight
Male Female
Civil Status: Citizenship Religion Email address
Single Married Divorced
Separated Widow/Widower
Present Address Home Phone No. Cellphone No.
Permanent Address Phone No.
Father (Surname, Firstname and Middlename) Mother (Surname, Firstname and Middlename)
Spouse (Surname, Firstname and Middlename) Occupation / Employer (Complete address)
Person to notify in case of emergency Complete address and contract number
Children’s Name (Surname, Firstname and Middlename) Date of Birth (Month, Day, Year)
1. 1.
2. 2.
3. 3.
Licensure Exam Taken: Date Taken: Expiration Date License Number
Highest Degree Completed
SCHOOL NAME AND ADDRESS Period Covered (Month and Year)
(indicate if undergraduate)
High School
College Degree:
Graduate Studies (Master Degree, Certificate/Diploma Program and Doctorate Degree) Degree: (Please indicate : Active Student Inactive Student)
1.
2.
3.
EMPLOYMENT HISTORY
PRESENT/RECENT EMPLOYER (Company Name) PREVIOUS EMPLOYER (Company Name) PREVIOUS EMPLOYER (Company Name)
ADDRESS ADDRESS ADDRESS
PHONE NO. PHONE NO. PHONE NO.
NAME OF IMMEDIATE SUPERRIOR & TITLE NAME OF IMMEDIATE SUPERRIOR & TITLE NAME OF IMMEDIATE SUPERIOR & TITLE
STARTING DATE SALARY STARTING DATE SALARY STARTING DATE SALARY
STARTING TITLE STARTING TITLE STARTING TITLE
MAJOR RESPONSIBLITIES MAJOR RESPONSIBLITIES MAJOR RESPONSIBLITIES
LEAVING DATE SALARY LEAVING DATE SALARY LEAVING DATE SALARY
LEAVING TITLE LEAVING TITLE LEAVING TITLE
NAME OF IMMEDIATE SUPERVISOR & TITLE NAME OF IMMEDIATE SUPERVISOR & TITLE NAME OF IMMEDIATE SUPERVISOR & TITLE
REASON/S FOR LEAVING REASON/S FOR LEAVING REASON/S FOR LEAVING
HR Form No. 02 – Employment Application Form
WORK REFERENCES
Name at least three (3) persons who have worked with you for the last three (3) years. Relatives are excluded
Name Occupation Relationship
Complete business and / or residence address Telephone Number / Mobile Phone Number / Email Address
Name Occupation Relationship
Complete business and / or residence address Telephone Number / Mobile Phone Number / Email Address
Name Occupation Relationship
Complete business and / or residence address Telephone Number / Mobile Phone Number / Email Address
Are you related to any DLS-CSB faculty/staff? Yes: No: . If yes, please list the name(s) up to the third of consanguity and /or affinity:
Has an administrative, civil or criminal case been filed against you in any court?
Yes: No: Kindly provide details:
SSS No. Philhealth
TIN Pag-Ibig
DATA PRIVACY POLICY
Please read the following privacy policy to understand how DLS-CSB uses and protects the information you provide.
1. De La Salle–College of Saint Benilde (DLS-CSB) is a registered Data Controller with the National Privacy
Commission. Personal information collected and processed by DLS-CSB is in accordance to the Data Privacy Act
of 2012.
2. Personal information shall only be used for recruitment and selection of applicants and for anonymized
reporting purposes.
3. The DLS-CSB shall not share personal information collected with anyone other than those authorized by the
College.
4. In the event of application resulting to an offer and acceptance of a position at the College, personal information
will be retained as part of the employee’s 201 file. Unsuccessful applicant’s personal information will be held
within the recruitment system and will be securely disposed of one (1) year after date of application.
By submitting personal information and application:
1. I declare that the information I have given in support of my application is, to the best of my knowledge and
belief, true and complete.
2. I understand that if it is subsequently discovered that any statement is false or misleading, or that I have
withheld relevant information, my application may be disqualified or, if I have been appointed, I may be
dismissed.
3. I give consent to the processing of the information contained in this application and any other personal
information I have provided separately in the manner and to the extent described.
4. I authorize DLS-CSB to verify or have verified on their behalf all statements contained in this application and to
make any necessary background reference checks.
I knowingly and voluntarily consent to De La Salle – College of Saint Benilde to the DLS-CSB Recruitment Process
_________________________________ __________
Applicant’s Signature over Printed Name Date Signed
HR Form No. 02 – Employment Application Form
Please answer each essay and questions below, not less than 100 words.
1. Tell me about a specific event when you had too many things to do and you were required to prioritize your
tasks.
2. Tell me about a recent situation in which you had to deal with a very upset customer or co-worker.
3. Describe a time when you were faced with stressful situation that demonstrated your coping skills
