usun lna:>1 f fl -61no (UK1?$U) 132 tl08lvSfYSlU[)S 7 lltl::>vUlvfFla

lt1ClUlvFlOllK8U nsolnW'1 10120

fns. 0-2289-3100-9 u\AinS 0-2291-1788

I SAHA PERSONNEL MANAGEMENT GROUP

luaiJfl'l-!ilU APPLICATION FORM

l 'U"ivtfl"ielfl°lJe) A113J �'3 t'U 1 u aar A"i 1 i��bii LIG'I bb��A"i'U01U PLEASE FII�IJ THIS APPI .. ICATl()N F()RM CLf:ARI .. Y AND COl\1PI .. ETEI .. Y

I CV d

1Uo/l DATE

b VI (;I� aar F11 L U�1bb VIU\ld'L �11: q

REASON FOR APPL YING THIS POSITION o I d do I

(;11 Lb VIU\l eJU o/l Fl �11 b VI 3-J1:a3-J OTHER POSITIONS

d CV CV ocv L VI i;it1 a3-J A 1'11 unuu1ero/l REASON FOR APPL YING WITH THE COMPANY

I c d di.I

b\lUb� eJU o/l (;l eJ\l n11 EXPECTED SALARY

NAME - SURNAME (ENGLISH)

1U b�eJU Ubfl� DATE OF BIRTH

CV

.. I O cv

.. , d 'lJ i;i 1 u 1:�1 i;i 1 u1:tf 1tfUb�tJo/l ID. CARD No.

CV CV

I

CV d

CV O I

a3-J Fl'i\11U(;11 bb VIU\I APPLIED FOR THE POSITION

1 U � a 13-J 11 tl b � 3-J ,J � 'Li� '11 U 1 iAVAILABLES FOR EMPLOYMENT

tl"i�1Gl a1uu A A� PERSONAIJ HISl"ORY

d o

at11ut1Ln� PLACE OF BIRTH

NATIONALITY

aanti ru ISSUED AT

eJ1tJ AGE

I

�eJL�U NICKNAME

F11au1 RELIGION

�'1Vl1� 1Uo/leJeJn 1UV13-J�eJ1tJ PROVINCE

TAX CARD No.

PRESENT ADDRESS I

'U1U 'Yl eJ � b UU?J eJ\l cu

HOUSE-BELONGING

�8u�1 FATHER'S NAME

I d I

o/l eJ tJ cu

ADDRESS I

�83-J11�1 MOTHER'S NAME

I

d I

o/l 8 tJ ADDRESS

a ti 1 u.n 1 � a 3-J 1 a MARITAL STATUS

SPOUSE'S NAME

SPOUSE'S OCCUPATION

No. OF CHILDREN

FM-HR-012, REV.1, 1 0.v. 2559

ISSUED DATE

□ tJ eJ\l (;IUbeJ\lOWNER

□ ta�SINGLE

d FlU'Yl No.

L�Fl SEX

eJ1tJ q

AGE

d n11F1n'bJ-1 EDUCATION

□ tJeJ\l'lJ�1-3-J11�1WITH PARENTS

u13-Jan�L�3-J q

MAIDEN SURNAME I

d o

ati1U'Yl'Yl1'11U NAME OF COMPANY

1

EXPIRED DATE I

'U i;i 1,J 1: flU�\l Fl 3-J L�tJyj SOCIAL CARD No.

Icv I.Id□ eJ1FltJt:JeJU

WITH ;THERS

81tJ q

AGE

eJ1tJ AGE

□ Vl3-J1tJWIDOWED

2

Tt11. TEL.

□ 'U1Ubtf1 RENT

81�� OCCUPATION

Tt11. TEL.

81�� OCCUPATION

t 'Yl'i.TEL.

□ VltJ1DIVORCED

3

d'Yl:: Lu t1ua3-J 1 a MARRIED'S CERTIFICATE

Lo/11. TEL.

4

0 CV

u1V1un WEIGHT HEIGHT

I

□ eJU 1OTHERS

CV I □ bbt1nnua�SEPARATED

□ �ES

5

d d"' �e.1 - ani.,t1eJ\l'W¾eJ\I

NAME OF BROTHERS AND SISTERS

1

2.

3.

4.

5.

€11 tJ AGE

... .._. d a I

t1 '1,1, L ";i fJ '1,1, / I.ii 1 LL YI '1,1, '1 CLASS I POSITION

� d a

5'11"AO'H-1 I 5f:11"'Yl'Yl1'11" NAME OF INSTITUTE / COMPANY

a(l1l-l,/l1'W'Yl1'1'Yl'Vl1';i MILITARY STATUS / ��"o::l11\l'Yl'Y\1';i'Yl�El 1a-J ARE YOU EXEMPTED FROM MILITARY SERVICE ?

□ �I YES

LFl 1:1 a,J a3-ltJo/l'VI ;e111-1 ORDINATION

□ 13-JLFIEI NO

LFIEIL i1f n�1i11 ut ';i\l'WfJ7'U1aeii'1tJ T ";iFI ANY PREVIOUS ILLNESS

I ';i Fl'U ";i:;,i'1 Gl'l PERSONNEL DISEASE

L tlua3,11B n a3-11 Fl 3-J LL a:: ii'1 n1":i 3-1 MEMBERSHIP IN ASSOCIATION AND ACTIVITIES

'11 'l,l,El (;l L 1 n HOBBIES

1::iun11Ffn�1 LEVEL OF EDUCATION

u1:::t1a.JRn1Y1 PRIMARY SCHOOL

ar iJ ti 3-1 A n�1 l.il e.JUGllb SECONDARY SCHOOL

ar 6 t1 3-1 Fl n,; 1 l.il e1 u ti � 1 t1 HIGH SCHOOL

i'Ylt11it1 1 e11fl1Flni,1 COLLEGE / VOCATIONAL

BACHELOR DEGREE

MASTER DEGREE OR HIGHER

a"t"�'1:::An�1 �eJVl�u 1a.J INTEND TO FURTHER STUDY

a ..., g I d07 i.1\'l t"I n"H-1 (;I e.l'Yl FURTHER STUDYING AT

ACTIVITY IN THE INSTITUTE

fl \l n';i';i 3-ln L Fl fJ�'l 3-J'l,I,[) n a '11 l-l,F{ fi'IY1 SOCIAL ACTIVITY

TRAINING COURSE

□ 13-J NO

□ LFltlYES

L 'YI I.ii r.J fi / REASON

L Ul-1,l 'Ji.,1 PERIOD

LtlUL'lfi1 L�EIU PERIOD YEAR

LLit11 n�tJL�elt,I ALLERGY BLOOD GROUP

' d d I 1"' nV11'YlLfi¾ (;l SPORTS/ GAMES

tJ1�1Glfll1Afl'M7 EDUCl\'l�ION BACKGROUND

..., d�

a ri 1 u " 1 ,., I.ii '1 INSTITUTE / LOCATION

fi11J1 MAJOR

□ auL'1 YES

□ t ¼U';i!:L l1A DOMESTIC

' '

a1t11 / Ln';itFIL\l�EI uriL i1An�1 MAJOR/ G.P.A. FROM

tJ'ti F11 (;l'J1"�'1'U n11 Fln1!1-1

YEAR OF GRADUATION

u'Yi,iu TO

L 'lel'1 atJ1Ulb ..., a

:;ti';i ::: fJ ::: L 'l i., 1 / 1 l-1, L Cil e.l '1.11 u

ITEMS INSTITUTE PERIOD / DAY MONTH YEAR

Jl11!J-1 LANGUAGE

11t1n11 ITEMS

o dd

���(;)(;)

TYPING Q d

FleJ��1LGlEl1 COMPUTER

I

eJU1 OTHERS

d

��1n EXCELLENT

A173.JGl73.J11tlLUfl71Liifl7Ml Lf\NGUAGE PROFICIENCY

SPEAK �1'" I Fl11�Li1L'1

READ / UNDERSTAND d

�

GOOD �e:itti FAIR

d

(;I �1 n

EXCELLEN

..,. '°117 3.J Gl73.J11tl'W tAM SPECIAL SKILLS

d o

d

�

GOOD

11t1a�LeJtJ� DESCRIPTION

�e:itti FAIR

LtltlU WRITE

d

��1n �

EXCELLENT GOOD �atti FAIR

d o □ 1'nt1 / THAI '"1Yla:: ............................... Fl1

(WORD I MINUTE) □ eJ\lnq'l!I- / ENGLISH '"1Yl�:: ............................. Fl1

(WORD I MINUTE)

□ ";i fl ti U Gl AUTOMOBILE

CV d□ 1fl'1n1tJ1'"tJ'"Gl MOTORCYCLE

OIV d.t u��ri I rii;i'1

tJ 1 �i'Gi n 11n 1 '11 uE�fJJLOYMENT RECORD

I

tu e:i '"ru 1 Gl iu ";J fl La t1 'Yi q ....

DRIVER'S LICENSE No.

l ua'"ru1 Glit11fl Latt�q ....

DRIVER'S LICENSE No.

d

L'Yl�fleltln �::EJ::L 1�1

PERIOD COMPANY/ LOCATION FIRST POSITION LAST POSITION STARTING SALARY FINAL SALARY REASON FOR LEAVING

I

0

L �3-J

START FROM

[1'1

TO

I 0

L �3-J

START FROM

[1'1

TO

I 0

L'S 3-J

START FROM

[1'1

TO

'U'1'1U'" o/l1\11U 'Yl PRESENT COMPANY .,

&1\ILL�1U / L�eJ'" / tJ FROM DAY / MONTH / YEAR

I o d o t;

L\l'"L�el'"L 1� Gl'" STARTING SALARY

I

YliZ 1'Yi LL a: r-111 �-ru � �?f au Li;] t:.1«-:1 L tttJ BRIEF OF DUTIES & RESPONSIBILITIES

L YI Gl� � � L 'Li� tJU\11U ..

REASON FOR CHANGING

LFl tlo/l1\11U L '"LFl�eJ aY1� (;lJU °1 �1 n El'" Yl�eJ 1� HAVE YOU EVER WORKING WITH SAHA GROUP

CV I

Gl \I LLGl FROM

o d

L\'l'"L�eJ'" SALARY

'Y11Ua1 �11flo/l1\11'"L U'"n: 1iYl�eJ 1� CAN YOU WORK FOR SHIFT

d�

Y1 Gl \'I ADDRESS

0 I

Gl1LL YIU\! LL 1n FIRST POSITION o d t;

L\l'"L� a'"a j;l Y11 tJ FINAL SALARY

□ 1�LFltJ NO

fl\l TO

d

a1 L YI (;lfleJ e:i n q

REASON FOR LEAVING

d O CV □ LFltlYltJ1�Yl YES, WHERE?

□ 1�1i NO

'Yi1'"�'"��'1:L6i'"Y11-:11 tJ�1-:1�\'IY11�Y1�e:1�1\'JtJ1:L Y1 Fl L �atJ�u�"'1'"LLa:1J ne:iu1� 1iYl�eJ 13-l ARE YOU WILLING TO TRAVEL UP COUNTRY OR SERVE THE OVERSEAS TRAINING?

o I t;

Gl1 LL Yl'"\I a�Y11tl q

LAST POSITION

o I

(;11 LL YIU\! POSITION

LYIGlCJa q

REASON

□ 1�1&i NO

LYIGlCJa REASON

I

eJLLU�u1 �el - an�� q

RECOMMEND BYI

d o

ari1u 'Yl'Y11'11U COMPANY'S NAME

I

wun\11Ul U'U�'i'Yl'Yl�el 1 ULFl�el"l riYi1ufin REFERENCE PERSONS IN THE COMPANY OR SAHA GROUP

I

�el - an� q

NAME-SURNAMEo I

(;11 LL 'YIU\! POSITION

I

t1a - an� NAME -SURNAME

o I

(;11 LL 'YI U'1 POSITION

'U Fl Fl� eJ1'1 a\'JUel n L 'YIUel'11 nu Fl Fl� L UFliel'U F1-r1 q q

o I

(;11 LL 'YIU'1 POSITION

REFERENCE PERSONS WHO ARE NOT YOUR FAMILY MEMBERS

�el - an� NAME-SURNAME

I d o

ari1u 'Yl'Y11'11U COMPANY'S NAME

I

�el - an� q

NAME-SURNAMEd o

ari1u 'Yl'Y11'11U COMPANY'S NAME

CV CV tr

Fl113-Ji;la.JWU5 RELATIONSHIP

□�ES

0 CV

'Ui'lY'Yl COMPANY

CV CV tr

Fl113-J aa.JWU5 RELATIONSHIP

0 CV

'Ui'lY'Yl COMPANY

CV CV tr

Fl'J13-J a 3-JWUu RELATIONSHIP

CV CV tr

Fl113-J aa.JWUu RELATIONSHIP

o I

(;11LL'YIU'1 POSITION

CV CV tr

Fl113-J aa.JWUu RELATIONSHIP

o I

(;11 LL 'YIU \I POSITION

" ,Q a.

�el3J � b CW3J bGl3J

ADDITIONAL INFORMATION

HAVE YOU EVER BEEN DISMISSED/ DISCHARGED FROM THE EMPLOYMENT?

HAVE YOU EVER BEEN ARRESTED, JUDGED OF A CRIME?

WORKING PHILOSOPHY

ADDITIONAL INFORMATION YOU WISH TO EXPLAIN MORE

□ 1�LFltJNO

□ 1�LFltJNO

□ LFltJ YES

□ LFleJ YES

L'Y11.TEL.

L'Y11.TEL.

t'Y11.TEL.

i;l 1 L 'YI (;l

CAUSE

i;l1 L 'YI (;l

CAUSE

i1�Li111afu«aeJ\l'J1 ieJFl11��tJ11 n!J LU L 'lJ a�FJ«aitL tJUFJ113-1'1�\i a�\!"lru� n &itl\io/l ntJ1�n11 Vl1 ntJ11 n!J L UJl1tlVI t'117it1 A11� L� 13-iL tJUA11 �'1�\i

i1� Li1 ti el 3-lf'lJ�'1�tJ�U� 617 � n!)"l� L 'LI tl'U1J el\lU�-J'Yl'YJ ntJ1� n11 I CERTIFY THAT ALL STATEMENTS MADE IN THE APPLICATION ARE TRUE. COMPLETE, AND CORRECT, ANY MISREPRESEt�TATION OR DISHONEST ANSWER

TO ANY QUESTION MAY BE CONSIDERED AS GROUNDS FOR MY IMMEDIATE DISCHARGE FROM EMPLOYMENT OF THE COMPANY WITHOUT SEVERANCE PAY.

'U1Wl;l1'lJ08U8U::>1U1c1Uf15\)1U foaauf1S lll

luldozjn1aldn1SUl)FlU KSO�nf11U1Cl 1

1U CV d CVO CV O I

CJ a 3-J Fl 13-J Fl ru a 3-J 'U (;l L 'YI 3-J 1 � a 3-J n 'U (;11 LL 'YI U\'I� q

THE QUALIFIED APPLICANTI CV tr cf 1U

t:J1un 11 a a.JJ11'lYru Lu eJ\'I 1nuFIRST INTERVIEW

INTERVIEWED BY SUPERIORI 1U d

t:J1un11'Yl in aauTESTED

□ 1.lelLtleJU WRITTING

CV d 1U 0

'JU 'Y1 L tl1'Y11'11U DATE OF EMPLOYMENT

LLCJUn DIVISION

CV d

'UU'Yl n?.lel\'I LLCJUn'U Fl Fl� q

PERSONNEL COMMENTS

QI d

• s

� � �\lnel ....................................................................... CJ�3-..JFI�

"'

SIGNATURE .............................................................................. APPLICANT

\JU'n n bbf.JU nu A A�

PERSONNEL COMMENTS

1

□ Jl1'lY1{;}1\'l'Ui�L'Y1Fl FOREIGN LANGUAGE

L U"11 LL 'YIU\'IPOSITION

�1tJ DEPARTMENT

2. 3.

CV □ tl'Uirl DRIVING

CV I 1U

ellni1Fl1'11\'ISALARY

□ elU 1 OTHERS