DATE OF

NAME BI RTH ADDRESS OCCUPATION COMPANY

(mm/dd/yyyy)
(Last Name, First Name Middle Name)
Father

Mother (Complete Maiden Name)

Brother/s

Sister/s

Spouse

Son/s

Daughterls

YES NO
Do your parents. spouse and/or children, or their companies (if'any).
have any loan or has availed of any credit I ine facility in BOO or in □ □
One Network Bank (ONB) 7

I. Do you have any existing :

YES NO
a. Loan
BDO/ONB □ □ Please specify
(Home/Auto/Personal etc.)
sss □ □
b. Credit Card
Pag-lbig □ □
BOO/ AMEX/Diners/JCB □ □
Others □ □ Please specify
2. Do you have any cancelled
card/s due to delinquency9
□ □ Please speci (y Outstanding Balance

3. Are you a co-maker of any

current BDO /O NB loan?
□ □ Please specify Loan Amount
 ame of Company Addres Date (mm/dd/yyyy) Position and Primary Responsibility
PRESENT/LAST JOB
Name: From: Position:

Address: To: Primary Responsibility:

Reason For Resignation:

SECOND LAST
Name: From: Position:

Address: To: Primary Responsibility:

Reason For Resignation:

THIRD LAST Name:

From: Position:

Address: To: Primary Responsibility:

Reason For Resignation:

Have you taken any Anti-Money Laundering Training/Seminar ? Please specify details below:
Title Held At Date Held

I.

2.

3.

4,

5.

Have you been employed in an insurance/ pre-need company before? UYesorUNo. If yes, please indicate: Do you

□ □
have an existing Ii cense to sell insurance? Yes or No

Name ofC ompany Date of Employment

When are you available for employment?

When necessary, are you willing to work on holidays ? on weekends? Do you wear
eyeglasses/contact lenses? □□
YES NO

Have you had any vision/ hearing problems? □ □

( Please specify )
Relatives (by Consanguiniry ar Affinity) employed with BDO Life or BDO Unibank Inc. and Subsidiaries (BDO Insurance,
BDO Capital, BDO Private Bank, BDO Leasing and Finance Inc .. One Network Bank)

Name Relationship Years Known

I. 2.
3.

Friends employed with BDO Life or BDO Unibank Inc. and Subsidiaries (BDO Insurance, BDO Capital. BDO Private Bank. BDO
Leasing and Finance Inc., One Network Bank)

Name Relationship Year Known

I.
2.
3.

Three (3) character references (Relatives)

Name Address Occupation Relationship Tel. No.

I. 2.
3.

Three (3) character references (Present & former employer)

Name Company Position Relationship Tel. No.

I.
2.
3.

Have you been involved in any administrative / civil / criminal case1 If

yes, indicate the ff:
Nature of Charge Date Filed Status/Decision/Outcome
THREE SPECIMEN SIGNATURES

Full Signature Initial / Short Signature

I I
2 23 3

I hereby certify that the above information are complete. true, correct. and accurate and I authorize BOO Life or its
authorized representative to investigate the veracity and truth of the foregoing information as I provided. and am aware
and recognize that I will be hired on that basis and that any misinformation or omis ion of pertinent facts herein will or may
constitute ground for discontinuance of my employment with the said company.

If employed, I promise and undertake to abide by the rules and regulations of this company.

Date Applicant's Signature

REFERENCE CHECK DETAILS

NAME: ------------- POSITION APPL YING FOR: ____

CONTACT NO.: ________

PRESENT/LAST EMPLOYMENT
COMPANY NAME

POSITION

DATE OF EMPLOYMENT (FROM/TO)

NAME OF LAST IMMEDIATE SUPERVISOR:

POSITION:

CONTACT DETAILS

NAME OF HR PERSONNEL / AGENCY

CONTACT DETAILS

SECOND LAST EMPLOYMENT

COMPANY NAME

POSITION

DATE OF EMPLOYMENT (FROM/TO)

NAME OF LAST IMMEDIATE SUPERVISOR:

POSITION:

CONTA CT DETAILS

NAME OF HR PERSONNEL/ AGENCY

CONTACT DETAILS

THIRD LAST EMPLOYMENT

COMPANY NAME

POSITION

DATE OF EMPLOYMENT (FROM/TO)

NAME OF LAST IMMEDIATE SUPERVISOR:

POSITION:

CONTA CT DETAILS

NAME OF HR PERSONNEL/ AGENCY

CONTA CT DETAILS

NOTE: This is a mandatory requirement. Kindly fill-up COMPLETELY to avoid any delays on the processing of your application.