APPLICATION FOR EMPLOYMENT

Please write all information in print. Indicate None or N.A. if Not Applicable. Date Accomplished
Position Applying For (The Bank has the prerogative to process applications for positions other than those cited by the applicant.)
1st Choice 2nd Choice 3rd Choice Date Available for Employment
July 25, 2022
Desired Salary
PHP 14,000
How did you find out about our job vacancies? PHOTO
■
Referral of Employee from: ● China Bank  China Bank Savings, Inc.  CBC Subsidiary 2” x 2”
Name of Referrer: Ms. Louchie A_nn A_._Alcancia
Direct Source Headhunter Jobstreet Linked-In
Campus Recruitment / Job Fair Review School Facebook
China Bank Website News Paper Referral of Applicant
Walk-in Drop Box (location) _ Others

PERSONAL INFORMATION
Last Name First Name(s) Middle Name Nicknames/Aliases/Other Names
Aquisap Dayanara Galvez Dayan

Personal E-mail Address Mobile No. 1 Mobile No. 2

galvezdayanara@gmail.com 0906-619-0717 N.A

Home/Permanent Address (Unit No./Floor, Building Name, Building/House No., Street, Subdivision/Village, Barangay, City/Municipality, Province, ZIP Code) Home Phone No.
N.A

Present Address (Unit No./Floor, Building Name, Building/House No., Street, Subdivision/Village, Barangay, City/Municipality, Province, ZIP Code) Home Phone No.
Same as Home/Permanent Address N.A.

Work/Business Address (Unit No./Floor, Building Name, Building No., Street, Subdivision/Village, Barangay, City/Municipality, Province, ZIP Code) Work/Business Phone No.
N.A.

Gender Place of Birth Civil

Status
Male ■ Female San Jose del Monte City, Bulacan Single Legally Separated Separated Divorced Widowed

■ Married Maiden Name: Galvez Dayanara San Jose

Last Name First Name Middle Name
Citizenship Height (In Feet and Inches) Weight (In Pounds) Religion
■
Filipino Naturalized Filipino
TIN SSS No. Pag-Ibig No. Philhealth No.
21-025272962-8
Languages Spoken Dialects Spoken
(1) Filipino (2) (3) (1) N.A (2) N.A. (3) N.A

FAMILY BACKGROUND
NAME OF FAMILY MEMBER CIVIL DATE OF BIRTH NAME OF COMPANY /
OCCUPATION / EDUCATION
(Last Name, First Name, Middle Name) STATUS (mm/dd/yyyy) SCHOOL
Spouse Aquisap, John Carlo Montecillo Married 12/20/1990 Wells Fargo
Eldest Aquisap, Damien Carlos Galvez N.A. 07/26/2019 N.A N.A.
nd
2
Children

3rd
4th

5th
Father Galvez, Ronaldo Garcia Deceased

Mother Galvez, Emelita San Jose Widowed

Eldest

2nd

3rd
Siblings

4th

5th

6th

7th
EDUCATIONAL BACKGROUND
YEARS ATTENDED
NAME OF SCHOOL DEGREE / COURSE HONORS
FROM TO
Grade School

High School

College

Post-Graduate

Review School

Other Studies

PROFESSIONAL QUALIFICATIONS / LICENSES / CERTIFICATIONS DATE OBTAINED DATE LAST RENEWED RATING

5
If yes, what course and when?
Do you have plans to pursue further studies? Yes No

Special Skills/Qualifications Hobbies

HRD-005 (10-17 TMP)

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What type of work are you best qualified for? What type of work would you like to get into eventually?

Which location would you prefer to be assigned to? (Note: The Bank reserves the right to assign/transfer any employee to Head Office or Metro Manila/Provincial Branches.)
Head Office (Makati) Metro Manila Branch Provincial Branch
WORK EXPERIENCE AND REFERENCES
PRESENT PREVIOUS (1) PREVIOUS (2) PREVIOUS (3)

Name of Company

Industry

Job Title

Rank

Gross Monthly Salary

From To From To From To From To
Inclusive Dates (mm/yy)

Reason for Leaving

Last Supervising Officer(s)

Name
(Last Name, First Name, Middle Initial)
Position/Rank

Contact Number(s)

Email Address

OK to Contact? Yes No Yes No Yes No Yes No

C H A R A C T E R R E F E R E N C E S (do not include relatives)

Name (Last Name, First Name, Middle Initial)

Name of Company

Position/Rank

Contact Number(s)

Email Address

Relation to the Applicant

OK to Contact? Yes No Yes No Yes No

OTHER INFORMATION
If yes, please state reason:
1. Have you ever been discharged from previous employment? Yes No

2. Have you ever been subjected to any company administrative or If yes, please provide details:
Yes No
legal proceedings?
3. Have you ever been charged, accused, indicted, or tried for If yes, please provide details:
Yes No
violation of any laws, ordinances, rules, or regulations?
4. Are you suffering or have you suffered from any physical, If yes, please describe ailment(s):
Yes No
psychological or any form of ailments?
If yes, please provide details:
5. Do you have any unpaid bills (e.g., utilities) presently past due? Yes No

6. Do you have any history of past due or cancelled credit cards, If yes, please provide details:
Yes No
or past due loans?

7. Have you previously applied or been employed with China If yes, where? When? _
Yes No
Banking Corporation or any of its subsidiaries? China Bank China Bank Savings, Inc. CBC Subsidiary _
8. Do you have any relatives/friends employed with China Bank or
Yes No If yes, please identify him/her/them in the spaces provided below:
any of its subsidiaries?
Name (Last Name, First Name, Middle Initial) Relation Company/Department/Unit/Branch

PERSON TO NOTIFY IN CASE OF EMERGENCY

Home Phone No. /
Name (Last Name, First Name, Middle Initial) Relation Mobile No. Office No. Address

CERTIFICATION
In submitting this Application for Employment, I hereby certify that all information herein given are true, complete, and correct.
I understand that employment in the Company requires absolute honesty. Thus, I acknowledge that any false statement and/or dishonest answer herein stated, or material omission, as hereinafter discovered, shall result
in disapproval of my application or constitute sufficient cause for my dismissal from employment, as the case may be.
To fully and completely assess my fitness, I also bind myself to submit to physical and medical examinations, including the government-mandated random drug-testing program, before and during my employment
with the Company.
Further, I hereby authorize the Company or its authorized/designated representative to conduct inquiries about my scholastic and employment records and verify all information stated in this application. In particular,
I hereby authorize the Company and its designated representatives to conduct a background and credit investigation on myself, which shall cover but shall not be limited to the following aspects and/or areas: (1)
National Government Agency Check, (2) Birth, (3) Citizenship, (4) Education, (5) Employment, (6) References, (7) Neighborhood, (8) Credit History, (9) Local Government Agency Check, (10) Record of
Involvement in Cases, be it administrative, criminal or civil in nature, whether past or present and (11) Family Relations. I understand that whatever information may be gathered by the Company relative to the above
enumerated aspects and/or areas of my personhood will be vital to the Company in its assessment of my merit and fitness to be part of its workforce, the same being an established Company engaged in an industry
impressed with public interest in the country, with known high regard for the integrity, trustworthiness and financial responsibility of its employees. In the event that my given application for officer/staff position
prosper into an employer-employee relationship between the Company and the undersigned, my herein signature shall constitute as my continuing authorization to the Company and its designated authorized
personnel to conduct a background and credit investigation on myself, as herein described, at any time it may deem necessary during my employment. This, I understand, has bearing on my merit and fitness to remain
an employee of the Company, the same being bound by the law, the regulatory powers and rules and regulations of pertinent government authorities, such as but not limited to, and as the case may be, the Securities
and Exchange Commission, Insurance Commission, and the Bangko Sentral ng Pilipinas, primarily the Manual of Regulations for Banks (MORB), more particularly in the case of Bank officers, the pertinent
subsections of its Sec. X143 on Disqualification of Directors and Officers.
Also, and in accordance with RA No. 10173 (Data Privacy Act), I hereby authorize the Bank to use my personal information, without notice, only if required to do so by law or in the good faith belief that such action
is necessary to: (a) assess my suitability for employment with the Company or any of its subsidiaries; (b) submit reports to Senior Management on recruitment strategies and demographics; (c) use as reference when
conducting reference checks; (d) conduct background/credit investigation; (e) conform to the edicts of the law or comply with legal process served on the Company and its subsidiaries; (f) protect and defend the
rights or property of the Company and its subsidiaries; and, (g) act under exigent circumstances to protect the personal safety of users of the Company and its subsidiaries, or the public.
In any event, and while having personal preferences on my future assignment(s), I understand and respect that the Company reserves the right to assign/transfer me to the Head Office or Metro Manila / Provincial
Branches, at any time and for any reason it may deem sound for its operations and business.

Applicant’s Signature Over Printed Name/Date

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