Address: Ul.

Inflancka 4C 00-189 Warsaw, Poland

Contact Phone Number: +48732100165

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

Name:

First: __________________________________ Middle: ________________________________ Last: ___________________________________

Nationality: ______________________ State: __________________________ City: ____________________________________

Passport Details:

Passport No: ______________________________ Issue Date: ____________________ Expiry Date: ____________________________

Permanent Address:

Street: _________________________ (Apt): __________________ City/State: _______________________ Zip Code: _______________

Alternative Address:

Street: _________________________ (Apt): __________________ City/State: ______________________ Zip Code: ________________

Contact Information:

Mobile Telephone: ____________________________________ E-mail: ________________________________________________________

Sex:
Male: ______________ Female: ______________ Date of Birth: ____________________ Place of Birth: _______________________

Marital Status:

Single: ___________________ Married: _________________________ Number of Children: __________________________________

Educational Qualification:

Position Applied: ______________________________ Job Experience: ______________________________________________________

Schools Attended:

Primary: ___________________________________________ Secondary: _________________________________________________________

University/ Polytechnic/ College of Education: _____________________________________________________________________

INFORMATION TO THE APPLICANT

As part of our procedure for processing your employment application, your personal and
employment references may be check, If you have misrepresented or omitted any facts on this
application, and are subsequently hired, you will be referred back for corrections..

You can take a written request for information’s derived from or for your references. If
necessary for employment, you may be required to provide your birth certificate or other proof
of authentication to work in Poland,

I hereby authorize the above listed references to release information as to my qualifications for
employment at General Electric (GE),
 I understand and agree to the information above.

Applicant Signature: ______________________ Date: _____________________________

Sincerely
Jakub Sokołowski
General Electric (GE)
Phone: +48732100165