Scribd
Upload
770 views4 pages

Personal Record Form

The document contains a personal record form with fields to capture an individual's personal details like name, date of birth, address, employment history, education, family details, salary history, disciplinary actions, and termination details.

Uploaded by

mesfinmulugeta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
770 views4 pages

Personal Record Form

The document contains a personal record form with fields to capture an individual's personal details like name, date of birth, address, employment history, education, family details, salary history, disciplinary actions, and termination details.

Uploaded by

mesfinmulugeta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 4

Form - 6: PERSONAL RECORD FORM

1. Full name: ________________________


2. Date of birth: ______________________
3. Place of birth: ______________________
4. Date of employment: _________________
5. Identity card No: ____________________
6. Sex: Male _________ Female _____________
7. Address woreda _________ H.No. _______Kebele _____ Tel. ____________
8. Marital status: Single ____ Married: _____ Divorced: _____ Widow _______
9. Name of Wife/Husband ______________________ Address woreda
___________ H.No. ________ Kebele _____ Tel._____________

10. Children's names and dates of birth

NameSexDate of Birth

1 ___________ _____ ________________


2. ___________ _____ ________________
3. ___________ _____ ________________
4. ___________ _____ ________________
+
11. Job Title/ Position at employment: _____________________
12. Department/program area at employment: ___________________
13. Salary/Allowance at employment: ______________________
14. Relative/Person to be contacted in case of emergency:

Name: _____________________
Position: ___________________
Address: ____________
Kebele: ______ H.No. _____ Tel. _________________ P.O.Box _____

15. Beneficiaries of pension/provident fund

NameAddress

1. _________________ _____________

2. _________________ _____________

3. _________________ _____________

1
16. Educational Standard

Name of Attended Grade Field of studies Remark


Educational
From _____ completed
Institute
To _______ .

- Experience

Employer Address Duration Work position Monthly salary


From - To
Initial Last Initial Last

17. Transfer

Date From work Position To work place position


place

- Promotion, change of salary and allowance

First promotion Second Third promotion


promotion
Date
Position
Salary
Allowance

2
18. Documents of acknowledgment and reward

Date Reason Type of Corresponding


acknowledgement benefit ,if any
and reward

19. Disciplinary measures

Date Type of disciplinary Action taken Remark


break

20.Additional information
______________________________________________________

Date of termination
______________________________________________________
Reason:
______________________________________________________

Employee Human Resource Manager

Name: ____________________ ______________________

Signature: _________________ ______________________

Date: ___________________ ______________________

3
4

You might also like