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 Fax No - 011-244-8763

E-mail Address: hr@daimeislk.com Web Address : http://daimeislk.com

PERSONAL HISTORY FORM

. . . .
1. 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, Police Clearance and upon receiptof satisfactory references. Family Name (Last name) First Name

Attach recent passport size photo

Middle Name

2.

Permanent Address Telephone Numbers Home Other

3.

Current Address Phone Postal Code E-mail

4.

Gender M F

5. Height (cm.)

6. Weight (Kg.)

7. Civil Status Single Married Other (Please specify)

Date of Birth DD MM

Place of Birth YYYY Age

9.

Citizenship

10

National ID Card No -

National Passport No Date of Birth Nationality Relationship DD MM YYYY

11 Family Members: (Spouse, Children, Parents, Parents-in-Law) Name (Family Name, First Name)

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 Good Reading Fair Slight Good Writing Fair Slight Good Speaking Fair Slight Understanding Good Fair Slight

16 EDUCATION: (Please give full details) A. Schools or other formal training from age 15 ( College, High School) Period of Attendance From School Name MM YYYY To MM YYYY Main Course of Study
Degree, Diploma Certificates, Awards orDistinctions Received

B. Technical College with Equivalent NVQ Level specified Period of Attendance From Course ,Technical College Name & City MM YYYY To MM YYYY Main Course of Study NVQ Level

C. University Education Period of Attendance From University , Facylty/School Name and City MM YYYY To MM YYYY Main Subjects Degree Earned

Period of Attendance D. Other Vocational Training Followed (SLT, CISCO, Auto CAD, CIMA) From MM YYYY To 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.

DD

From MM

To YYYY DD MM YYYY Starting

Monthly Salary Latest

Position/Job Title: 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:

DD

From MM

To YYYY DD MM YYYY Starting

Annual Salary Latest

Position/Job Title: 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? If "Yes", why?

Yes

No

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 34 Do you smoke? Yes Week's Time No Other (Please specify)

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.

Attach recent passport size photo

Date of Birth YYYY

Understanding Slight

Degree, Diploma Certificates, Awards orDistinctions Received

NVQ Level

Degree Earned

Diploma, Certificate or Equivalent

YYYY

Number and Category of Employees you Supervised:

Occasionally

information given above. I understand that any misrepresentation or material omission made herein or in any

s the statements you have made above. Do not, however, send any documentary evidence until you have been asked