SOP 1 Annex G (HRD PIS-F01)

PHARMA NUTRIA N.A., INC. S.V. MORE PHARMA CORPORATION PNSV ASIA CORPORATION

S.V. More Group Corporate Center Recent Photo

#16 Scout Tuason cor. Roces Ave., Quezon City, Metro Manila, Philippines (2 x 2)
Telephone Nos.: 373-6240 * 373-6242 * 373-6591
Fax Nos.: 371-1428 * 375-1721 * 371-1649

PERSONNEL INFORMATION SHEET

Please complete all items either by inserting the correct information or ticking/circling the relevant item.

I. PERSONAL CIRCUMSTANCES:
Warehouse
Position Applied for: __________________________________________

Full Name: Santi P. Desalisa Nickname:

___________________________________________________________ _________________________

Current Home Address: 518 silencio sta. mesa, manila Contact No. 09453374798
___________________________________________________________ _________________________

Provincial/Permanent Address: 69 ml quezon st. tanay, rizal

__________________________________________________________________________________________

Date of Birth: 07/02/95 Place of Birth: Tanay, Rizal Citizenship: Fil Age: 27 Sex: male
_______________ _____________________ ______________ ____________ ____________

In Case of Emergency Notify: (Indicate Name and Relationship) Nancy Desalisa / Mother
__________________________________________________________________________________________
ggggggi
Address and Contact No.: 0966 481 6999
__________________________________________________________________________________________

II. FAMILY:

Status: N/A
Name of Spouse:________________________ Number of Children:_______________

Single Name and Ages of Children: Name and Ages of Children:

________________________________ _____________________________
Married ________________________________ _____________________________
________________________________ ____________________________

Name of Dependents/Other Dependents: Relationship:

_________________________________________________________ ________________________________
_________________________________________________________ ________________________________
N/A
_________________________________________________________ ________________________________

Next of Kin (Parents/Siblings):

Name: Name:
__________________________________________ __________________________________________
__________________________________________ __________________________________________
__________________________________________ __________________________________________
__________________________________________ __________________________________________
III. EDUCATION:
Schools Attended: Principal Field of Attended Graduated Honors/Awards
Study/Degree Earned: From To Yes No Received:

BS Fisheries
_________________________ ______________________ _____ _____ ____ ____ _________________

_________________________ ______________________ _____ _____ ____ ____ _________________

_________________________ ______________________ _____ _____ ____ ____ _________________

_________________________ ______________________ _____ _____ ____ ____ _________________

Professional license(s) held: Describe any additional education you have received:
__________________________________ ___________________________________________________
__________________________________ ___________________________________________________

Are you presently devoting any time to special study? (Describe fully)
__________________________________________________________________________________________
__________________________________________________________________________________________

State special skills or machines you can operate:

__________________________________________________________________________________________
__________________________________________________________________________________________

IV. EMPLOYMENT HISTORY:

From: To: Company Name and Address Last Position Salary
Mo. Yr. Mo. Yr.

_____ _____ _____ _____ _____________________________ _________________ ___________

_____ _____ _____ _____ _____________________________ _________________ ___________

_____ _____ _____ _____ _____________________________ _________________ ___________

_____ _____ _____ _____ _____________________________ _________________ ___________

_____ _____ _____ _____ _____________________________ _________________ ___________

May we contact your present employer at this time? May we contact your previous employers? (Yes/No)
(Yes/No) ________________________________ If yes, which ones? _____________________________

V. DETAILS OF EMPLOYMENT EXPERIENCE

Following the form below, describe your work in each of the last three companies in which you have been employed. Start with
the last or present company. Be complete. Be especially careful to give all details of work experiences during your
employment. Please use additional sheets if necessary.

1.) Firm: Immediate Supervisor:

_________________________________________________________ ________________________________

Reason for leaving:

__________________________________________________________________________________________
__________________________________________________________________________________________
 Give job titles and description of duties, responsibilities and accomplishments:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

2.) Firm: Immediate Supervisor:

_________________________________________________________ ________________________________

Reason for leaving:

_________________________________________________________________________________________
__________________________________________________________________________________________

Give job titles and description of duties, responsibilities and accomplishments:

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

3.) Firm: Immediate Supervisor:

_________________________________________________________ ________________________________

Reason for leaving:

__________________________________________________________________________________________
__________________________________________________________________________________________

Give job titles and description of duties, responsibilities and accomplishments:

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

VI. PREFERENCES AND RELATED MATTERS ABOUT THE COMPANY:

What salary do you desire? Names of employees of this company with whom you
________________________________________ are acquainted?
_____________________________________________
What date could you begin work if employed by _____________________________________________
this company? ____________________________ _____________________________________________

Have you ever applied work with this Company Names of any relatives/in-laws in this Company’s
before? (Yes/No)__________________________ employ?
_____________________________________________
Who referred you to this Company? _____________________________________________
________________________________________ _____________________________________________

Why are you applying for a position in this If employed by the Company, do you have marked
Company? preferences for a particular area? (Yes/No)
________________________________________ If yes, area preferred and reasons:
________________________________________ _____________________________________________
________________________________________ _____________________________________________
________________________________________
________________________________________ Second preference:
________________________________________ _____________________________________________
________________________________________ _____________________________________________
VII. REFERENCES:
Please list three references other than relatives or former employers. Mark with an asterisk those you do not
wish us to contact at this time.

Name: Position Company/Company Address Contact No.

_________________________ __________________ ______________________________ ____________

_________________________ __________________ ______________________________ ____________

_________________________ __________________ ______________________________ ____________

I hereby certify that all information contained herein is true and correct to the best of my knowledge.

______________________________________
Signature over Printed Name

______________________________________
Date
ANNEX
MEDICAL HISTORY:

1. Previous Illness/es:

Year Findings / Diagnosis Status / Remarks

____________________ ______________________________ ____________________________________
____________________ ______________________________ ____________________________________

2. Last Medical Check-Up:

When Where Findings / Diagnosis

____________________ ______________________________ ____________________________________

3. History of Hospitalization/s and/or operation/s:

When Where Findings / Diagnosis

____________________ ______________________________ ____________________________________
____________________ ______________________________ ____________________________________

4. State any ailment, illness or physical condition presently bothering you:

_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
5. State medicine/s you are currently taking:

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
6. Indicate illness/es you consider yourself more prone or vulnerable to:

______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
7. Have you ever experienced bouts of anxiety, irritability or depression, serious enough to interfere with your work and
your relationships with friends, family, or co-workers?

______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
8. How many times did it occur? Please specify date, period and duration.

______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________

9. Are you currently receiving, or have you in the past received treatment/medications for any emotional or psychological
problems? If yes, please specify medications prescribed by your attending physician and diagnosis.

______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
CONFORME:
I understand that this questionnaire is to assist the occupational medical staff in determining my suitability to perform
the functions of the positions for which I have applied at _____________________________________.

_________________________________________
Printed Name & Signature of Applicant/Date