APPLICATION FORM PHOTO

I. GENERAL INFORMATION
Last Name First Name Middle Name

Dela Cruz Juan Santos

Nickname Mobile No. Home Tel. No. Email Address
Juan 09171234567 [email protected]
856-4439
Present Address Position Desired
Blk 21 Lot 2 Phase 3 Sunset Subd. Brgy. Masaya Pasay, City Sales Associate
Birthdate (mm/dd/yyyy) Gender Civil Status Citizenship

03-16-1992 Male Female Married Filipino

TIN SSS No. Philhealth No. HDMF No.

321-123-456 03-4298765-4 0224-1244-5678 1212-3456-7890
II. APPLICATION QUESTIONNAIRE
1. How did you learn about the job opportunity? (Please check the appropriate box and specify name of the provider in the space)
Job Fair Referred by: ____________________ School Placement Office Walk-in
Jobstreet Search firm/Agency: ____________________ Others: ____________________
2. Do you or your spouse have any relative/s employed in SM or its Affiliates?
Yes (Please answer the required information below) None, proceed to question no. 3

Name Relationship Company Name Position

3. Do you or your spouse have any relative/s who are contractors/service providers/suppliers of SM or its Affiliates?
Yes (Please answer the required information below) None, proceed to question no. 4

Name Relationship Company Name/Position Service Provided to SM

4. If hired, how soon can you start working? 5. Have you ever been convicted of any crime? If YES, give details.
Immediately Week/s after notice: _______________ Yes ________________________ No

6. Are you willing to relocate? 7. Are you willing to travel?

Yes No Will Consider Yes No Will Consider

8. Have you ever applied or worked with SM or its Affiliates before? 9. Do you have any pending applications with other companies?
Yes No If yes, when? _______________________ Yes No

III. EDUCATIONAL ATTAINMENT

Name of School Degree / Major / Honors Years Attended (From - To)
High School
Pasay National Highschool June 8, 2005 - April 8, 2009
Vocational

College
Pasay National College BS Office Administration June 8, 2009 - April 13, 2011
Post Graduate

IV. EMPLOYMENT HISTORY (Indicate last 4 companies worked with; start from the most recent; skip if not applicable)
Inclusive Dates
Company/Address & Contact Number Position Reason for Leaving
From To
ABC Company 11-22-2013 09-19-2015 Office Staff Change of Residence
Brother and Sisters Apparel Inc. 12-03-2015 05-08-2016 Sales Associate End of Contract
Love Group of Companies 06-07-2016 08-26-2018 Sales Representative Family Matters

V. FAMILY BACKGROUND
Spouse Name Children's Names Father's Name Mother's Maiden Name
Ana F. Dela Cruz Charles F. Dela Cruz Juanito G. Dela Cruz Corazon Mendez Santos

VI. CHARACTER REFERENCES (Should not be a relative)

Name Company Position Contact Number

Piolo Cruz ABC Company Admin Supervisor 09182247887

Carmela Sanchez Brothers and Sisters Apparel Inc. Store Manager 09472269987
Ivan Tuazon Love Group of Companies Store Supervisor 09156782134
VII. ACKNOWLEDGEMENT AND AUTHORIZATION

I hereby affirm to the best of my knowledge and belief that all the answers to the foregoing are true and correct.
I acknowledge that the filing of this application does not entitle me to any acquired right to employment and Mini Depato Corp. may dispose of this application in any manner it so desires.
I also authorize Mini Depato Corp. to collect and process my personal data in accordance with the purposes provided in the Privacy Consent form I have executed and to inquire and/or verify my
record/s from any or all of my former employers / the schools I attended. Consequently, I hereby release and discharge the Company from any and all claims, proceedings and/or liability which may
arise from such inquiry. I further acknowledge that any misrepresentation in the foregoing answers and data given shall be sufficient grounds for my dismissal from Mini Depato Corp.

Juan S. Dela Cruz October 29, 2021

Applicant's Name and Signature Date Accomplished
 DATA PRIVACY CONSENT FORM

Juan S. Dela Cruz

I, _______________________________ (applicant/employee/consultant) hereby grant my express,
unconditional, voluntary and informed consent to, and hereby authorize, _________________________
MINI DEPATO CORP.

(“Company”), including but not limited to its HR, Medical, IT, Legal, Tax, Finance and Accounting
departments, authorized personnel and service providers (“personal information personnel”), to collect,
store, access and/or process in any way, means or method, whether manually, electronically or
automatically, my personal data necessary for the purposes of and in the course of my application,
employment (if accepted) or any contractual relationship with the Company, or termination or cessation
of such application, employment or contractual relationship, hereinafter collectively referred to as the
“Purposes”, including but not limited to carrying out data analytics, management, profiling, manual or
automated decision-making and any activity in furtherance of the Purposes.

I further grant my express, unconditional, voluntary and informed consent to, and hereby authorize, the
Company, including its authorized personnel, to share, transmit or transfer my personal information to its
parent company, subsidiaries and affiliates of the Company (collectively referred to herein as “Company
Affiliates”), to act as personal information controller and/or personal information processor, and to
subcontract or outsource the processing of my personal information to third parties acting as personal
information processors on behalf of the Company (“external service providers”) for the abovementioned
Purposes, as well as authorize and grant my express, unconditional, voluntary and informed consent to,
and hereby authorize, the said Company Affiliates and external service providers, if any, to collect and
process my personal information for the abovementioned Purposes.

I hereby knowingly and voluntarily acknowledge and confirm that I have been duly informed of my rights
under the law with respect to my personal data as well as of the Purposes of the processing, sharing,
transmittal or transferring, or the subcontracting or outsourcing of the collection and processing of my
personal information.

I hereby knowingly and voluntarily acknowledge the due execution, validity and effectivity of this Consent
Form, and hereby confirm that I have executed the same of my own volition and free will.

Juan S. Dela Cruz October 29, 2021

_____________________________________ _________________
Name & Signature Date
 REFERENCE CHECK CONSENT FORM

NAME : __________________________________
Juan S. Dela Cruz POSITION : _________________________
Sales Associate

I. Employer References

Name of Immediate Head Position Title Company Name Contact Number

Piolo Cruz Admin Supervisor Admin Supervisor 09182247887

1. ___________________ ___________________ __________________ ________________
2. Carmela Sanchez
___________________ ___________________
Brothers and Sisters Apparel Inc. Store Manager
__________________ ________________
09472269987
3. Ivan Tuazon
___________________ ___________________
Love Group of Companies Store Supervisor
__________________ ________________
09156782134

II. School References

Name Course/Degree College University Contact Number

1. Krishia Mae Lopez

___________________ BS Office Administration
___________________ Pasay National College ________________
__________________ 09274559212
2. ___________________ ___________________ __________________ ________________
3. ___________________ ___________________ __________________ ________________

III. Community References

Name Occupation Address Contact Number

1. Hermenio Salazar
___________________ Brgy. Chairman
___________________ Pasay City
__________________ 09126783390
________________
2. ___________________ ___________________ __________________ ________________
3. ___________________ ___________________ __________________ ________________

IV. Character References

Name Occupation Company Name Contact Number

/ Address

1. Angelo Dizon
___________________ Store Manager
___________________ ABC Company
__________________ 09468372219
________________
2. ___________________
Melody Alonzo Professor
___________________ __________________
PUP 09172298882
________________
3. ___________________
Grace Diaz ___________________
HR Director __________________
XY Company ________________
09567116810

MINI DEPATO CORP.

I hereby authorized _______________________ to conduct background check from any or all the
above listed references. I understand that the information that is collected during the background
check will be limited to that which is appropriate in determining my suitability for a particular
position and that such information will be kept confidential. I also agree to release the company from
any liability or damages from such inquiry.

JUAN S. DELA CRUZ

_______ _____________________
Signature over printed name