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BakesIsMukargar
EMPLOYMENT APPLICATION FORM

4x6

muxtMENgesIsMu
Position applying for:

R)ak;ebovtS kEngeFVI r_EdlrMBwg kar Tuk Location:

Expected Salary: /M PERSONAL DATA

1.

Tinnypal;xn

f Ex TIkEngkMenIt sBaati Nationality: qaMkMeNIt Date of Place of Birth:

Birth:

elxGtsBaaNbN
ID Card No:

elxlixitqgEdn

Passport No:

sanPaBGaBah_BiBah_ Marital status: enAlIv Single o erobkar Married o Gasydanbcb,n GasydanGciRny_ Present address: (sMrab;EtbuKlikbreTs bMeBj) Permanent Address (For Overseas elxTUrsB
E-mail Address: Employee Only) Telephone No.

elxTUrsB
E-mail Address:

Telephone No.

BtmanGMBIsmaCikRKYsar

Family member information:

eQaH
Name

TMnak;TM muxtMENg elxTUrsB Business Position ng

Relationship Telephone No.

karTMnak;TMngeBlmanGasn In case of emergency contact: eQaH TMnak;TM muxtMENg elxTUrsB Name Business Position ng
Relationship Telephone No.

etIGkmanTMnak;TMngCamYybuKlikEdrrWe T? Do you have any relationship with staff? )aT Yes o eT No o RbsinebImansUmpl;BtmanxageRkam if the answer is
"yes", give the following information:

eQaH
Name

f Ex muxtMENg TMnak;TM Position qaMkMe ng Relationship NIt

Date of birth

cMeNHdwgTUeTA GENERAL EDUCATION sUmpl;BtmanlMGit sUmpl;eQaHmuxviC anig kMritsikSaeGay)anc,as;las; Please give full details
2. exact titles or degrees.

BI From dl; To eQaHsaklviT Ex Ex kMritEdlT muxviC Month/ Month/ aly TYl)an a qa qa Degrees obtained Name (Universities or Equivalent) Major of study M Year M Year

B. Courses.

vKbNHbNal rW vKsikSaxI

Formal Training or Short

BI From dl; To sBaab Ex Ex Rt rW eQaHRKws RbePTmu Month/ Month/ lixitbBa ansikSa xviCa qa qa ak;karsi Name of institution Type of subjects M Year M Year kSa
Certificates or Diplomas obtained

3.

PasabreTs FOREIGN LANGUAGES Gan Read sresr Write ex m l ex m l Pasa Sa F Good Sa F Good Language y m y m
Poor Fair Poor Fair

niyay Speak sab; Listen ex m l ex m l Sa F Good Sa F Good y m y m

Poor Fair Poor Fair

Exr
Khmer

Gg;eK s English cin

Mandarin

Rbvtikargar EMPLOYMENT HISTORY Kitcab;epImBImuxgarbcb,n ehIyerobrab;tamlMdab;nUvral;kargarEdlGk) aneFVI Starting with your present post, list in reverse order every employment you have had.
4.

muxgarbcb,n (muxgarcugeRkay ebIsinCabcb,nKankargar)

Present Post ( Last Post, If Not Presently In Employment) A.

muxtMENgBitR)akd Exact title of your post: BI From dl; To R)ak;ebovt plRbeyaCn_epSg Benefits: Sr_RbcaMEx
Monthly Basic Salary (U.S Dollar)

Other

Ex
Month/ year

Ex
Month/ year

qaM qaM

cab;e bBa pIm b;

Starting Ending

eQaHRkumhun rWGgkar Company/Organization Name: GasydannieyaCk Address of

employer:

eQaHRbFan Name of
supervisor:

mUlehtulaQb;BIkarga r Reasons for leaving: karBiBNnaParkic Description of your duties

B.

muxtMENgBitR)akd Exact title of your post: BI From dl; To R)ak;ebovt plRbeyaCn_epSg Benefits: Sr_RbcaMEx
Monthly Basic Salary (U.S Dollar)

Other

Ex
Month/ year

Ex
Month/ year

qaM qaM

cab;e bBa pIm b;

Starting Ending

eQaHRkumhun rWGgkar

Company/Organization Name:

GasydannieyaCk Address of
employer:

eQaHRbFan Name of
supervisor:

mUlehtulaQb;BIkarga r Reasons for leaving: karBiBNnaParkic Description of your duties

ksareyag REFERENCES erobrab;mnusS 3nak;EdlminBak;BnCamYyGk ehIysal;BIcritlkN nigKuNsm,tirbs;Gk

5. List three persons, not related to you, who are familiar with your character and qualifications.

eQaH Full name

Gasydan nigelxTUrsBTMn ak;TMng

Address and contact number

muxtMENg
Occupation

6.

GMnGMnagrbs;ebkCn APPLICANTS DECLARATION

sUmbBaak;fa ral;BtmanTaMgGs;Edl)anpl;xagelI KWBitCaRtwmRtUv eBjelj nigCak;lak;BitR)akdEmn.

I certify that all data and information which I have provided above are true, complete, and correct to the best of my knowledge and belief.

htelxaebkCn Signature of Applicant kalbriecT Date *** sMKal; Note: sUmPab;mkCamYynUvksarftcMlg dUcCa GtsBaaNbN rW lixitqgEdn esovePARKYsar sMbuRtkMenIt nigsBaabRt rWksareyagepSgeTotmkCamYypg.
Please attach with a copy of your ID Card or Passport, Family Book, Birth Certificate, Educational and Relevant Certificates or document.