Application form

Personal
(Print) Last Name First Name Middle Name Nickname

Present address Home Phone No. 2” X 2” ID photo

(Please write your

Permanent address Home Phone No. complete name at the back
of the photo before
attaching it to this form.)

Mobile phone number E-mail address

Father’s name and age Occupation and employer Employer address

Mother’s name and age Occupation and employer Employer address

Spouse’s name and age Occupation and employer Employer address

Other relations (siblings and children)

Name Relation Age Occupation, company Address of company/school
name/school

Person to contact in case of emergency Relation Address Contact number

Career
Type of application Of the following lines of services, please rank your preference with 1 being your first choice to 3 being your last.

____ Assurance – Financial Audit ____Deals Advisory – Strategy

____ Assurance – Risk Assurance (Internal / IT Audit) ____Deals Advisory – Valuation
____ Tax ____Deals Advisory – Due Diligence
____ Tax – Worldtrade Management Services ____Deals Advisory – M&A and Corporate Finance
____ Employment
____ Financial Crime (Operations) ____Deals Advisory – Infrastructure Advisory
____ Internship
____ Advisory – Risk & Forensics Consulting ____ Client Accounting Services (Accounting, Payroll, Tax Compliance)
____ Scholarship ____ Advisory – Technology Consulting ____ Human Capital (Practice Support)
____ Advisory – Management Consulting (Finance) ____ IT (Practice Support)
____ Advisory – Management Consulting (Operations) ____ Clerical/Secretarial (Practice Support)
____ Advisory – Management Consulting (HR) ____ Others
This page is optional for experienced applicants.

Tertiary education
Degree/course Dates attended (mm/yy) Standing in General Honors/
School name and address class (top weighted scholarships/
From To 10%, 25% av erage awards receiv ed
or lower
50%)

In what college activities did you participate? (academic/non-academic organizations) Dates attended (mm/yy)
Name of organization Position/s held From To

Graduate and post-graduate education

Degree/course Dates attended Standing in General Honors/
School name and address
(mm/yy) gradua ti n g weighted scholarships/
class (top av erage awards receiv ed
From To 10%, 25%
or lower
50%)

Licensure examination/s
License/s or professional Date Rank Rating License Review school Dates attended
certificates obtained obtained number (mm/yy)
(CPA Board, Bar, CISA, From To
CIA, CFA, PMP, etc.)

Board exam rev iew

Date of exam Rating Place / Rank

1 st pre-board
nd
2 pre-board
3 rd / final pre-board

2 of 4
 General information
Approximate monthly minimum salary desired Have you applied in PwC (the firm) before? If yes, when & where?
PHP  Yes  No
Soonest date to start work Travelling restrictions Other companies applied to &
status of application

Are you related to anyone in this firm or in any other accounting/consulting firm?
 Yes  No Position & nature of relationship:
How did you learn about us?
 Campus Recruitment/Job Fair  LinkedIn  Walk-In  Others
 Career Site  Jobstreet  Referred By:
Health
Do you currently have, or have you ever had, a medical (physical or mental) condition that could reasonably be expected to affect your
ability to carry out the work of the position applied for or which could reasonably be expected to be aggravated or contributed to by the
work of the position applied for?  Yes (If you answer ye s, plea se specify )  No

Administrative & criminal offense/s

Have you ever been convicted of any administrative and/or criminal offense?  Yes  No
Do you have any administrative or criminal charges pending or under investigation?  Yes  No
If you answer yes, please explain.

Reference checks
Personal (not relativ e) (1) Personal (not relativ e) (2)
Name: Name:
Position: Position:
Mailing address: Mailing address:
Contact number: Contact number:
E-mail address: E-mail address:
Academic (1) Academic (2)
Name: Name:
Position: Position:
Mailing address: Mailing address:
Contact number: Contact number:
E-mail address: E-mail address:
Prev ious employer (1) Prev ious employer (2)
Name: Name:
Position: Position:
Mailing address: Mailing address:
Contact number: Contact number:
E-mail address: E-mail address:
Warranty & waiver
In case I am not hired, I am allowing the firm to refer me to other companies for their job vacancies.

Signature over printed name Date

3 of 4
Pre-Employment Screening
Consent Form I al so declare that I have given written consent to the references I have indicated in
my application form, curriculum vitae, Pre-Employment Screening Data Form,
and/or in any other form/document I have shared to PwC, to share my personal
Isl a Lipana & Co., a member firm of PricewaterhouseCoopers (PwC), conducts pre- i nformation to persons and/or entities whom I seek employment, including PwC.
employment screening checks of all the applicants for positions in PwC.
I f urther declare that I have been informed by PwC of my rights under the Data
Please read the following carefully: Pr ivacy Act of 2012, including but not limited to my right to be informed, object,
ac c ess, rectify, erase, damages, data portability and file a complaint.

To sc reen your application effectively for a position, PwCwill source and/or verify I authorize PwC to undertake the pre-employment screening enquiries set out in the
i nformation regarding some or all of the following: Pr e-Employment Screening Consent Form. Particularly, at any time once I have
si gned and returned this consent form to PwC, I consent and authorize PwC to:

 Your legal right to work in the Philippines;

 Pr oof of your identity and current residence; i. Col lect, store, organize, update or modify, retrieve, consult, use and
 Educ ational and professional qualifications/memberships; c onsolidate the data, including personal information, I have shared to
 Employment history and proof of activity (this involves checking how and verified by PwC
y ou have been previously – for instance, checking periods of work, career ii. Perform reference checks of my employment (i.e., my past and current
b r eaks etc.); employment), education, professional qualifications and background
 Cr iminal record check which involvesrequesting clearance and iii. To c onfirm and/or verify the presence of and/or to secure a copy of my
v erification with the National Bureau of Investigation (NBI) and/or CIBI w ritten consent to share my personal information from the references I
Inf ormation Inc.) have indicated in my application form, curriculumvitae, Pre-
Employment Screening Data Form, and/or in any other form/document
 Cr edit and insolvency check.
I have shared to PwC
iv. Share the information obtained and verified to any PwC affiliates, related
To undertake the above checks, PwC may contact your current and previous entities or other member companies
employers, educational and professional institutes you have attended and/or of v. To provide and share the data, personal or otherwise, available to PwC,
w hich you are a member, and organizations which hold criminal record information. w hich I have included on my application form and/or curriculum vitae
and/or Pre-Employment Screening Data Form to organizations and
i ndividuals for the purpose of these organizations and individuals
The results of PwC’s enquiries may contain personal data, which may include v erifying that information and disclosing relevant information to PwC
i nformation about your background, character and personal reputation. vi. Tak e appropriate security measures to prevent unauthorized access,
i mproper use or disclosure, unauthorized modification or unlawful
destruction or accidental loss of my data.
The information obtained from PwC’s enquirieswill be used toverify the information vii. Destroy the documents containing my data in any manner which PwC
pr esented on your application form and/or curriculum vitae and/or Pre- thinksis best to protect the confidentiality of the information, which shall
Employment Screening Data Form, to assess your suitability for employment within i nclude but not limited to destruction by fire.
Pw C. PwCwill store the results and enquiries, as well asinformation provided by you,
on y our personnel file and in a secure employment screening database accessible only I f urther release and forever discharge PwC, its affiliates, related entities or other
to selected PwC staff. PwC will store the pre -employment screening enquiries, results memb er companies, respective partners and employees, from any and all claims,
and related information for nolonger than is necessary for the purpose of these pre- demands , damages, actions, causes of action, or suits of any kind or nature
employment screening checks and, if appointed, your employment within PwC. w hatsoever arising from enquiries of my credentials and background.

In order to carry out these screening enquiries of your background, PwC requires I understand that the information contained in and attached to my application
y our consent. By agreeing to the statement below, you will be consenting to PwC f or m/curriculum vitae and the results of the pre-employment screening enquiries
pr oviding data included by you on your application form and/or curriculum vitae w ill be included in my personnel file and held confidentially on a PwC employment
and/or Pre-Employment Screening Data Form to organizations and individuals who sc r eening database as long as necessary for the purpose of theses pre-employment
hol d personal information about you for the purpose of these organizations and sc r eening checks and, if appointed, my employment with PwC.
i ndividuals verifying that information and disclosing relevant information to PwC.
Inf ormation about you will only be retained and used by PwC in accordance with
r elevant data protection legislation.

For any questions relating to the personal data held by PwC in relation to this Pre- ________________________________________________
Employment Screening Data Form, please send an email to [email protected] Pr inted Name with Signature
or a letter to the following address:

Data Protection Officer Date

Isl a Lipana & Co.
29th Floor Philamlife Tower
87 67 Paseo de Roxas1226 Date of Birth
Mak ati City, Philippines
Pl ease also list any other names by which you are currently/ have previously been
k nown (e.g. maiden name).
Declaration & authorization

I declare that the information I have provided in connection with my application for a
position, at PwCis true and complete to the best of my knowledge. I understand that
the provision of false and misleading information may lead to the withdrawal of any
employment offer or, if appointed, to disciplinary action or termination of my
employment contract.

Page 4 of 4