0% found this document useful (0 votes)
10 views7 pages

TMS Personal History Form

Uploaded by

primkabui25
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
0% found this document useful (0 votes)
10 views7 pages

TMS Personal History Form

Uploaded by

primkabui25
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 7

NOBLE OUTLOOK LIMITED

PERSONAL HISTORY FORM PASSPORT


PHOTOGRAPH
(All fields must be filled)
A. PERSONAL DATA:

Surname: _________________________ Other Names:


__________________________

___________________________________________________________________________

Position Offered:
___________________________________________________________

Date Appointed: ____________________ Nationality:


_________________________
Date Of Birth: _____________________ Place Of Birth: ______________________
Gender: ___________________________ Telephone:
____________________________

Email: ____________________________________________________________________

Marital Status: Single: ___________ Married: __________ Other: ________

Name of Spouse:
___________________________________________________________

Spouse Telephone Number:


_________________________________________________

Spouse ID No: ……………………………….. (Attach Copy)

Names Of Children.

1. __________________________________ 3.
_______________________________

2. __________________________________ 4.
_______________________________

Present Address: (Area of Residence)

County: ___________________________ Estate Name: _________________________

Road/Street: _______________________ Building Name:

_______________________

Nearest Landmark: _______________________________________________________

Page 1 of 7
Rural Home Address:

Village Name: _____________________ Sub-Location:

________________________

Location /Ward: ___________________ County: _____________________________

Nearest Rural Home Police Station:


________________________________________

Name And Address of Persons to Contact In Case Of Emergency -


(Relatives):
Name: ___________________________________________________________________
Relationship: _____________________ Telephone No.: _______________________
Residence: _______________________________________________________________

Name: ___________________________________________________________________
Relationship: _____________________ Telephone No.: _______________________
Residence: _______________________________________________________________

Statutory Details:
ID No./PP No: ______________________N.S.S.F. No: _________________________

N.H.I.F: ___________________________ PIN No.: ____________________________

Bank Details:

Bank Name: ____________________________ Branch: _______________________

Account Number: _________________________________________________________

B. Education History:

Primary:
School Attended:
__________________________________________________________
Period: ________________________________ Marks Attained: ________________

Page 2 of 7
Secondary: School Attended______________________________
School Attended:
__________________________________________________________
Period: ________________________________ Grade Attained: ________________
Higher Education:(College/University)
Institution: _____________________________ Course:
_________________________
Cert/Dip/Deg Awarded: ___________________ Dates:
__________________________
Others (Specify):
___________________________________________________________
Knowledge of Languages:
Language Speak Read Write Understand
(A) _____________ _______ _______ _______ ___________
(B) _____________ _______ _______ _______ ___________
(C) _____________ _______ _______ _______ ___________

8. Special Qualifications/Abilities:
______________________________________
__________________________________________________________________________

C. Employment History:

Last Employment

Employer: ________________________________________________________________
Position Held: ___________________________ Salary:
_________________________
Employment Date: __________________ ____ Leaving Date:
______________________
Reasons For Leaving:
______________________________________________________
Name, Telephone & Email of Immediate Supervisor:
_________________________
__________________________________________________________________________
Previous Employment:

Page 3 of 7
Employer: ________________________________________________________________
Position Held: ___________________________ Salary:
_________________________
Employment Date: __________________ ____ Leaving Date:
______________________
Reasons For Leaving:
______________________________________________________
Name, Telephone & Email of Immediate Supervisor:
_________________________
__________________________________________________________________________

Previous Employment (Immediately Prior to the Above).

Employer: ________________________________________________________________
Position Held: ___________________________ Salary:
_________________________
Employment Date: __________________ ____ Leaving Date:
______________________
Reasons For Leaving:
______________________________________________________
Name, Telephone & Email of Immediate Supervisor:
_________________________
__________________________________________________________________________

Other Experience:
________________________________________________________
__________________________________________________________________________
D. Other Qualification:

Driving Experience:
Driving License No. _____________________ Date Of Issue:
____________________
How Many Years Have You Driven?
_________________________________________
Have You Ever Been Involved In An Accident?
_______________________________
If Yes Elaborate:
___________________________________________________________
___________________________________________________________________________

Page 4 of 7
E. Give Names of Three Professional Referees (Not Relatives):

1. ___________________ _____________
________________
Name: Relationship:
Telephone No & Email

2. _______________ _____________
_______________
Name: Relationship: Telephone No &
Email

3. _______________ _____________ _______________


Name: Relationship: Telephone No &
Email

Family Details

Spouse Offspring/Children
Surname: Child 1 Date Of Birth
Middle Name:
First Name: Child 2
Occupation:
Employer Name: Child 3
Mobile No:
Email Address: Child 4
Id Number:
Residence/Town: Child 5

Parents
Father Mother
Surname: Surname:
Middle Name: Middle Name:
First Name: First Name:
Id Number: Id Number:
Mobile No: Mobile No:
Residence (Village Residence
Name) (Village Name)

BENEFICIARY NOMINATION FORM

In the event of my death or incapacitation while serving with Noble


Outlook Ltd, I hereby nominate the following beneficiaries to receive all

Page 5 of 7
my benefits and monies due to me at the date of separation from the
Organization:

(This nomination cancels and supersedes any previous nominations)


Full Names of each Year Ag Relationshi Shares to be
Beneficiary of e p with the paid to each PHONE NUMBER
birth beneficiary Beneficiary OF BENEFICIARY
Percentage
(%)
1

The share of any beneficiary who may pre-decease me shall be distributed


equally among the surviving beneficiaries.

I understand that if the person nominated is under the age of 18 years at


the time of my death, any benefits becoming payable may have to be
paid to the Public Trustee to be held in trust until such person attains the
above age. Furthermore, I understand that it is solely my responsibility to
inform Noble Outlook Ltd in writing should I wish to change the names of
the beneficiaries and until that time this declaration shall be the sole
nomination respected by Noble Outlook Limited.

Unless indicated otherwise above, I understand that if more than one


person is nominated any benefits accruing will be divided amongst the
persons as per the said above percentages.

NEXT OF KIN DETAILS

Name: ____________________________________________________________________

Relationship: _______________________ ___ Telephone No:


___________________

Physical Residential Address (Estate, Street Name, House no):


________________

___________________________________________________________________________

Postal Address: ____________ Code: ___________


Town______________________

Page 6 of 7
I ________________________________________________Declare that the information
given above is true to the best of my knowledge. I am aware that false or
incorrect information given by me will result in my termination of my
continuation with the company.
SIGN: ………………………… ID: ……………………….. DATE: …………………………

WITNESS:

I, the undersigned, having no financial interest in this subject matter,


directly or indirectly, hereby certify that this document was signed in my
presence by the designator on the _____________ day of _____________ in the
year____________

Name of witness: _____________________________ Signature:


__________________

Address: _____________________________________ Date: _____________________

Page 7 of 7

You might also like