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First Name:
Contact Number (s): Mobile
Home Telephone:
Email Address:
Current Employer:
Current Role:
Project Name:
Current Location:
Highest Education Attainment:
Reason for Leaving:
Total Years Experience:

Last Name:
Date of Birth:

Total Oil & Gas Experience:

Are you a Permanent Staff Employee or a Contract Employee?

Staff/Permanent Employee

Contract/Temporary Employee

If Contract/Temporary Employee, please specify the duration and if contract is renewable.

1. Is your compensation split across several countries? (Yes or No)
If YES, please detail the countries and split percentage

2. In which country (or countries) are you being paid by your current employer?

3. In which country or countries do you pay personal income tax?

4. In which countrys social security system do you participate?

5. What is your monthly salary Specify Basic & Gross & Net (Mention only Salary paid every month,
Facilities that are not provided by allowance in salary please tick in below question no 5)





6. What benefits do you have apart from Salary mentioned above ?

( ) Car provided by company
( ) Car personal leasing support/car allowance
( ) Car with driver provided
( ) Fuel card: international/national
( ) Representation allowance
( ) Foreign service/Hardship allowance
( ) Accommodation
( ) Household utilities (electricity, water, etc.)
( ) Personal education/language school
( ) Schooling for dependents
( ) Paid home leave
( ) Daily expenses
( ) Health care cover
( ) Paid home leave: during vacations only/any time
( ) Health care cover
( ) Accident cover
( ) Pension (please detail type and contributions e.g. defined benefit/defined contribution)
( ) Other (please detail below)
( ) None of these
7. Please provide details of your expected Salary (Monthly Basic Salary in USD)

8. What short term incentives do you have?

( ) Bonus Plan
( ) Others (please specify)
( ) None
Please detail frequency and value, the basis for the award (company and/or personal performance), and
the amount your received in each of the last two years.

9. How many days paid vacation do you have?

10. What is your notice period?

11. Please provide 2 Professional References (Will be used only on your confirmation)

Company Name:

Contact number(s):

Name :
Company Name:

Contact number(s):

12. Information gathered is OK to be released to Hays Oil & Gas Client?