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Highly Confidential

JOB APPLICATION FORM

Position Applied For Date Filed (MM/DD/YYYY)

PERSONAL INFORMATION

Please provide all information in print


Last Name First Name Middle Name Suffix

Maiden Name / Other Name Date of Birth (MM/DD/YYYY) Sex Civil Status

Nationality Contact No. Best Time to Call

Email Address

ADDRESSES for the last 7 years

Number / Street / Village

Barangay State / City Province

Country Postal Code Years of Stay (MM/YYYY)

From To

Number / Street / Village

Barangay State / City Province

Country Postal Code Years of Stay (MM/YYYY)

From To

Number / Street / Village

Barangay State / City Province

Country Postal Code Years of Stay (MM/YYYY)

From To

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
Highly Confidential

EDUCATIONAL BACKGROUND

Highest Completed Education Details (Please Do Not Fill Pursuing Education)

Name of Institution

Number / Street / Village State / City / Province Country Postal Code

Name in School Records

Educational Attainment (Post-Graduate / College / Diploma / Vocational / Senior HS / High School): if college undergrad, please put high
school graduate:

Dates Attended (MM/DD/YYYY)

From To

Date of Graduation (MM/DD/YYYY) Course of Study

Honors / Awards Received Student No.

Professor / Teacher’s Name Contact No. Best Time to Call

PROFESSIONAL QUALIFICATIONS/MEMBERSHIPS

List information according to your most recent professional license / certification

Date of Examination /
Civil Service / R.A. 1080 Place of Examination / Date of Validity
Conferment License Number
(Board / Bar) Conferment (MM/DD/YYYY)
(MM/DD/YYYY)

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
Highly Confidential

EMPLOYMENT HISTORY

List information according to your most recent employer for the last 5 years

Name of Company Contact No. / Email ID: Alternative Contact No. / Email ID: Employee ID No.

Number / Street / Village State / City / Province Country Postal Code

If employed through an agency, kindly indicate the name and contact information of the agency:

Name of Agency: Address: Contact No.:

Status of Employment

Regular Contractual Probationary Seasonal / On-Call

Dates of Employment (MM/DD/YYYY)

From To (for currently employed, kindly indicate last working day)

Most Recent Job Title Department

Can we contact your current employer? (Kindly indicate N/A if not applicable)

Yes No If No, please indicate the date of availability:

Reason for Leaving: Salary / Financial Probity (if applicable to verify the credit check)

Job Responsibilities:

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
Highly Confidential

Name of Company Contact No. Alternative Contact No. / Email Employee ID No.
ID:

Number / Street / Village State / City / Province Country Postal Code

If employed through an agency, kindly indicate the name and contact information of the agency:

Name of Agency: Address: Contact No.:

Status of Employment

Regular Contractual Probationary Seasonal / On-Call

Dates of Employment (MM/DD/YYYY)

From To

Most Recent Job Title Department

Can we contact your current employer? (Kindly indicate N/A if not applicable)

Yes No If No, please indicate the date of availability:

Reason for Leaving: Salary / Financial Probity (if applicable to verify the credit check)

Job Responsibilities:

Name of Company Contact No. Alternative Contact No. / Email ID: Employee ID No.

Number / Street / Village State / City / Province Country Postal Code

If employed through an agency, kindly indicate the name and contact information of the agency:

Name of Agency: Address: Contact No.:

Status of Employment

Regular Contractual Probationary Seasonal / On-Call

Dates of Employment (MM/DD/YYYY)

From To

Most Recent Job Title Department

Can we contact your current employer? (Kindly indicate N/A if not applicable)

Yes No If No, please indicate the date of availability:

Reason for Leaving: Salary / Financial Probity (if applicable to verify the credit check)

Job Responsibilities:

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
Highly Confidential

PROFESSIONAL REFERENCES

Name Contact No. Other Contact No. / Email Address

Employer Job Title

Relation / Affiliation Best Time to Call

Name Contact No. Other Contact No. / Email Address

Employer Job Title

Relation / Affiliation Best Time to Call

Name Contact No. Other Contact No. / Email Address

Employer Job Title

Relation / Affiliation Best Time to Call

CHARACTER/PERSONAL REFERENCES

Name Contact No. Other Contact No. / Email Address

Employer Job Title

Relation / Affiliation Best Time to Call

Name Contact No. Other Contact No. / Email Address

Employer Job Title

Relation / Affiliation Best Time to Call

Name Contact No. Other Contact No. / Email Address

Employer Job Title

Relation / Affiliation Best Time to Call

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
BACKGROUND SCREENING CONSENT

I declare that the information I have provided in the Job Application Form, and in any submitted and/or attached documents, is
true and complete to the best of my knowledge and belief, and that I have answered the questions fully and accurately.

I understand that my pre-employment background screening will include any or all of the following checks:

Any or all of the following will be checked:

• Address Check • Financial Probity


• References Check • Basic Criminality and/or International criminal
• Eligibility to Work background check via jurisdictional court data
• Identity Check • Media Search
• Employment/Education History • Sanction List
• Professional Qualifications/Memberships • Directorship Search

I authorize Vanguard Screening Solutions Inc., as the data processor, an independent agent acting on behalf of my prospective
employer, as the data controller, to verify information presented in my Job Application Form, in any submitted and/or attached
documents, which may include personal and sensitive information for the purposes of compliance with the Philippine Data
Protection Act of 2012 (DPA) and/or the data protection legislation relevant to another country, as applicable. I understand and
agree that, where my personal history required background verifications to be carried out in countries where I have worked
and/or resided, in respect of my employment or education or residence, my data may be sent and processed in those relevant
countries and be governed by applicable data protection legislation which is relevant to the country specified.

I also authorize Vanguard Screening Solutions Inc. to (a) verify my academic/professional qualifications (and for educational
establishments to release information) as well as my employment, including my current employer; (b) contact the appropriate
in-country government departments or agencies to confirm periods of unemployment, if applicable, and to access my personal
online SSS account to check my records upon instruction of my employer; (c) contact the Identity and Passport Service, if
required; (d) perform an international criminal records check (as appropriate); and (e) receive and copy the results of the
checks at their office addresses and communicate the results to my prospective employer. I understand that the results of my
screening will be communicated by Vanguard Screening Solutions Inc. to my prospective employer who in turn may keep a
copy on my personnel file. I understand and accept that Vanguard Screening Solutions Inc. may contact me and my referees
by telephone, email or mail for the purposes set out above. I confirm that my consent is explicit, fully informed and freely given
for the purposes of the background verifications stated above.

Signature :

Full Name :

Maiden Name or Other Name :

Date :

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
HCL Technologies Philippines Inc.
Centrewide Function Level Work Instruction
ISO 9001- 2000 – HCL Technologies Philippines Inc. Manila Center

Name of the Document: Application Form


Name of Department: Talent Acquisition Management
Issue No.: 00 Prepared By: Ann Castillo (Manager - TAG) Revision No.: 01
First Released on: June 29, 2016 Approved By: Bruno Shailen (Global Head, TAG) Document No.: 001

Location: Manila Document Class: Internal

Date of Application: Position Desired:

Have you ever applied in HCL before? Y | N Have you ever applied to any HCL affiliates before? Y | N

How did you learn about us?


Specify
[] Online (FB, Jobstreet etc)

(Name & SAP ID)


[] Employee Referral

Event Name
[] Job Fair/ Events

Vendor Name
[] Vendor/ Headhunter

Specify
[] Walk in (Word of Mouth/ Ad)

Specify
[] others:

Most recent Compensation Package:Basic Asking Compensation Package:


Salary:
Allowance:

AVAILABILITY
[]Y [ ] N []Y [ ] N
Night Shift Can Start Immediately

[]Y [ ] N []Y [ ] N
Weekends/ Rotating Shift Needs 15 Days Notice

[]Y [ ] N []Y [ ] N
Overtime Needs 30 Days Notice

EMPLOYMENT: RELEVANT EXPERIENCE


BPO
TOTAL YEARS OF BPO EXPERIENCE From To
[ ] Voice [ ] Non Voice
IT
TOTAL YEARS OF IT EXPERIENCE From To

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
ADDITIONAL INFORMATION REQUIRED
Kindly put check on the tick box.

1. Have you ever been arrested or convicted of any criminal offense? ☐ Yes ☐ No
If yes, please provide details

Is the case still pending? ☐ Yes ☐ No

2. Have you ever been declared bankrupt or had a petition of bankruptcy? ☐ Yes ☐ No

If yes, please provide details:

3. Have you ever been involved in any civil judgments, as a Plaintiff or Defendant? ☐Yes ☐ No
If yes, please provide details

4. Have you ever been refused entry to any country? ☐ Yes ☐ No


If yes, please provide details

5. Have you ever been terminated or dismissed by any employer? ☐ Yes ☐ No


If yes, please provide details

6. Have you ever been involved in any act of violence? ☐ Yes ☐ No


If yes, please provide details

7. Are you currently engaged in any other business either as a proprietor, partner, director, trustee, and employee or
otherwise? ☐ Yes ☐ No

If yes, please provide details:


8. Are you willing to work onsite every day at the office? ☐ Yes ☐ No
9. Do you have any medical conditions that might prevent you from working on-site or on-shifting schedule? ☐ Yes ☐ No

If yes, please provide details:


10. Are you willing to work in shifting schedule or even night shift; depends on the account? ☐ Yes ☐ No

11. Are you okay to be aligned in a voice LOB? ☐ Yes ☐ No

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com
Declaration
I hereby certify that all information provided in this form is accurate and complete to the best of my knowledge. I
understand that any misrepresentation and/or falsification of any fact may result in cancellation of employment or
immediate dismissal.

I recognize that in connection with my job application, I may be subjected to a background check and hereby authorize
the same.

Letter of Authorization

I hereby authorize HCL Technologies Philippines, Inc., and its background screening partner/vendor and its associates
to verify information provided in my form for background screening purposes. I authorize all persons who may have
information relevant to this enquiry to disclose it to background screening partner and its associates, and release all
persons concerned from liability on account of such disclosure. I hereby voluntarily affix my signature and represent this
document to be an original.

I further authorize the procurement of a consumer credit report or other like documents and understand the report may
contain information on my background, mode of living, character, and personal reputation. I further consent to the review
and release of any information from my military records deemed necessary.

I further acknowledge, consent and agree that photocopies of this Letter of Authorization may bemade and used as if they
were original copies.

Signature :
Full Name :
Date of Birth : (MM/DD/YYYY)
Identification No. : (Government issued ID)
Date :

Vanguard Screening Solutions, Inc.


VSSI-ISMS-OPS-Job Application Form v1.0 10F The Belvedere Tower, 15 San Miguel Ave
Ortigas Center, Brgy. San Antonio, Pasig City, Philippines 1605
+632 7621 7435 | Fax: +632 8857 2312 | www.vanguardscreen.com

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