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Don't Edit The Application Form !Applicant ID No.
DAIMEI SLK (PVT.)Ltd.Level 10, Ceylinco House,
No - 69, Janadhipathi Mawatha, Colombo 01.
Telephone No - 011-244-8760 E-mail Address: [email protected]
Fax No - 011-244-8763 Web Address : http://daimeislk.com
PERSONAL HISTORY FORM
. Please type or print your answer to each question clearly and completely. Do not write in shaded areas.
. Read and follow carefully all the directions given.
. The maximum validity period for a Personal History Form is two(1) years from date of receipt.
. Appointments to the staff of DAIMEI SLK will be valid only after you passed the prescribed medical examinations, Attach recent passport size photo
Police Clearance and upon receiptof satisfactory references.
1. Family Name (Last name) First Name Middle Name
2. Permanent Address Telephone Numbers
Home
Other
3. Current Address
Phone
Postal Code E-mail
4. Gender 5. Height 6. Weight 7. Civil Status
M F (cm.) (Kg.) Single Married
8 Date of Birth Place of Birth 9. Citizenship
DD MM YYYY Age
10 National ID Card No - National Passport No -
11 Family Members: (Spouse, Children, Parents, Parents-in-Law) Date of Birth
Nationality Relationship DD MM YYYY
12 If you have a spouse, specify his/her current occupation and name of organization.
13 Name of person to be notified in case of emergency 14 Telephone Number
Complete Address
15 Beginning with your native language, enter all languages you know. Please indicate your proficiency by marking the appropriate box.
Language Reading Writing Speaking Understanding
Good Fair Slight Good Fair Slight Good Fair Slight Good Fair Slight
16
A.
Period of Attendance
From To Degree, Diploma Certificates,
School Name MM YYYY MM YYYY Main Course of Study Awards orDistinctions Received
Other (Please specify)
Name (Family Name, First Name)
EDUCATION: (Please give full details)
Schools or other formal training from age 15 ( College, High School)
B. Technical College with Equivalent NVQ Level specified
Period of Attendance
From To
Course ,Technical College Name & City MM YYYY MM YYYY Main Course of Study NVQ Level
C. University Education
Period of Attendance
From To
University , Facylty/School Name and City MM YYYY MM YYYY Main Subjects Degree Earned
Period of Attendance
From ToD. Other Vocational Training Followed (SLT, CISCO, Auto CAD, CIMA) MM YYYY MM YYYY Key Subjects Completed Diploma, Certificate or Equivalent
17 Other special Qualifications & Abilities
18 Extra Curricular Activities
19 List all computer softwares which you are familiar with. Indicate your proficiency (i.e. "L" for low; "A" for average; "H" for High)
20 Do you possess a valid Driving License Yes No
If "Yes" - Categories of Vehicles you are permitted to Drive
21 Have you worked in Daimei? If "Yes", indicate date.
Yes No DD MM YYYY
22 EMPLOYMENT RECORD: (Starting with your present/latest job, list every job you have had. Use a separate block for each job. Include also service in the armed forces
and periods during which you were not gainfully employed. If you need more space, attach additional pages of the same format.
From To Monthly Salary Position/Job Title:
DD MM YYYY DD MM YYYY Starting Latest
Name and Position of Supervisor:
Others (e.g. Bonuses, etc.)
Number and Category of Employees you Supervised:
Name and Address of Organization:
Reason for Leaving/Wanting to Leave:
Nature of Business: Telephone No.
Describe your Work:
From To Annual Salary Position/Job Title:
DD MM YYYY DD MM YYYY Starting Latest
Name and Position of Supervisor:
Name and Address of Organization: No. and Category of Employees you Supervised:
Reason for Leaving:
Nature of Business:
Describe your Work:
23 State any other relevant facts. Include international experience, stating place and duration.
24 Have you any objections to our making inquiries with your present employer? Yes No
If "Yes", why?
25 REFERENCES: List three persons, not related to you, who are familiar with your character, qualifications and competence whom DAIMEI SLK may contact at any time.
Full Name and Job Title Full Address / E-mail / Fax Name of Business
26 Do you have physical defects or disabilities?
Yes No If "Yes", please specify:
27 Have you ever suffered from any serious nervous disorders or contagious diseases?
Yes No If "Yes", give details.
28 Are you physically able and willing to travel?
Yes No By Air? Yes No Frequently Occasionally
29 Have you ever been arrested, indicted or summoned into court as defendant in a criminal proceeding or convicted, fined or imprisoned for the violation of any law
(excluding minor traffic violations)?
Yes No
30 Do you have any kinsman currently working at DAIMEI SLK ?
Yes No
If "Yes", Name -
31 Post applied for
32 What approximate starting salary will be acceptable to you for the position you have in mind?
per month
33 If your services are required at the earliest possible time, how soon will you be available to start work after being found suitable and physically fit for employment?
Immediately Week's Time
34 Do you smoke? Yes No
I certify that the statements made by me in answer to the foregoing questions are true, complete and correct to the best of my knowledge and belief. Permission is given to
DAIMEI SLK to make such investigations as are necessary on the information given above. I understand that any misrepresentation or material omission made herein or in any
other document requested by DAIMEI SLK renders a staff member liable to termination of service or dismissal.
Date: Signature:
You will be requested to supply documentation evidence which supports the statements you have made above. Do not, however, send any documentary evidence until you have been asked
to do so by DAIMEI SLK, and in any event, do not submit the original texts of reference or testimonials or publications unless they have been obtained for the sole use of DAIMEI SLK.
Other (Please specify)
