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Personal Data Form

Personal Data Form

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omoyegun
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
73 views

Personal Data Form

Personal Data Form

Uploaded by

omoyegun
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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PERSONAL RECORD

Passport photograph
[This form is to be completed in capital letters]

Employee ID Number:

Starting Date:

Position:

Assigned Client Company:

PERSONAL INFORMATION

Name:
Surname First Name Middle
D / M / Y
Gender:  M  F Religion Date of Birth
______________

Nationality: State of Origin Hometown

Local Government Area of Origin:

Personal Email Address:

National Identification Number:

Official Email Address:

Contact Address:

Tel:

Tel:

Residential Address:_

Tel:

Tel:

Marital Status: Spouse’s Name:


(Single, Married, Separated, Widowed)
Spouse’s Occupation

Spouse’s Daytime Address

Tel:

By completing this form, you hereby consent to the collection, use, and transfer, in electronic or other form, of your data as described in
the Nigeria Data Protection Act, 2023.’
Children: Names Date of Birth

D / M / Y

1. _________________________________________________ ____________________

2. _________________________________________________ ______________________

3. _________________________________________________ _______________________

4. _________________________________________________ ________________________

Next of Kin: Relationship:

Contact Address:

Tel:

Tel:

EDUCATIONAL QUALIFICATION

Schools attended: Period: Qualification:

_______________________________ ________________________ _______________________

________________________________ ________________________ _______________________

_________________________________ _________________________ ________________________

MEDICAL INFORMATION

Blood Group: (i.e. O+, A+) Genotype: (i.e. AA, AS, SS, SC)

Allergies: Diabetic?  Yes  No Epileptic?  Yes  No

Please indicate other diseases:

Hobbies:

By completing this form, you hereby consent to the collection, use, and transfer, in electronic or other form, of your data as described in
the Nigeria Data Protection Act, 2023.’
EMPLOYMENT HISTORY

Organization Position Period

1._______________________________ _______________________________ ______________________

2._______________________________ _______________________________ _______________________

3._________________________________ _________________________________ _______________________

4._________________________________ ________________________________ _______________________

EMPLOYMENT REFERENCES:

1. last Two Employers 2.

Name: Name:

Address: Address:

Phone Number: Phone Number:

Email Address: Email Address:

GUARANTORS:
1. Non-Family Guarantor 2. Family Guarantor

Name: Name:

Phone number: Phone number:

Address: Address:

Employer: Employer:

Office Address: Office Address:

Email Address: Email Address:

PENSION DETAILS

Pension Fund Administrator Name:

Pension Fund Administrator Pin. PEN:

By completing this form, you hereby consent to the collection, use, and transfer, in electronic or other form, of your data as described in
the Nigeria Data Protection Act, 2023.’
SALARY ACCOUNT DETAILS

Bank Name:

Bank Account No: For Office Use:


Yes No
Bank Sort Code: ID Card Issued
Home Located
Bank Branch: References Taken Up?
Access Card Issued?
Employee Signature: Utility Bill
Copy of Driver’s License
Copy of Int’l Passport
National ID card

By completing this form, you hereby consent to the collection, use, and transfer, in electronic or other form, of your data as described in
the Nigeria Data Protection Act, 2023.’

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