INTEQC GROUP APPLICATION FORM
JOB APPLICATION FORM
INTEQC FEED LAB PRIMA LIVE
 77/12 Moo.2, Rama 2 Road, Nakhok, Muang, SamutSakhon 74000
Position or Type of Work 1)
Minimum Salary Required
baht / Month
  2)
Date Available for Employment
  3)
   
Personal Details
Name Mr./Mrs./Miss   Surname   Nick Name  
Date of Birth   Age  55 Place of Birth   Identification No.  
    
    
    
    
    
    
    
    
    
    
    
    
    
Issued at   Issued Date   Expired Date  
Weight   Height   Race   Nationality   Religion   Place of Birth  
Number of Brother/ Sister: Including the Applicant    Male    Female   Sibling No  
Marital Status Single Married Register Unregister Divorced  Widowed
Spouse’s Name   Age   Occupation   Number of Children   Tel.No  
Military Service Yes No / If no, specify when 
If exempted, specify reason
Permanent Address  
Tel.Home   Mobile Phone   E-mail Address  
Contact Address for Interview Same as the Permanent Address
Other Address		  
Family Details
Father’s Name   Living Aged   Deceased
Occupation   Address   Tel.No  
Mother’s Name   Living Aged   Deceased
Occupation   Address   Tel.No  
Emergency Contact
1. Name Tel.Home Tel.Office 
Mobile Phone Relationship 
2. Name Tel.Home Tel.Office 
Mobile Phone Relationship 
Education Background
Education Level Institute Name Period Major Subject Certificate/Diploma/Degree GPA
From To
       
       
       
       
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Public Activity  

Previous Employment
From To Period Previous Employer’s Name & Address Business Type
Position
Salary
start end start end
                 
Responsibility of Job  
Reason for Leaving  
From To Period Previous Employer’s Name & Address Business Type
Position
Salary
start end start end
                 
Responsibility of Job  
Reason for Leaving  
From To Period Previous Employer’s Name & Address Business Type
Position
Salary
start end start end
                 
Responsibility of Job  
Reason for Leaving  
From To Period Previous Employer’s Name & Address Business Type
Position
Salary
start end start end
                 
Responsibility of Job  
Reason for Leaving  
From To Period Previous Employer’s Name & Address Business Type
Position
Salary
start end start end
                 
Responsibility of Job  
Reason for Leaving  

Training
Institute Subject / Course From To Certificate
     
     
     
     
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Language Ability
Language Specify : Excellent , Good , Fair , Poor
Speak Read Write
Thai
English
Others    
Other Ability
Typing : WPM. Driving : Yes No Driver’s License
Thai    Car      
Eng.    Motorcycle      
Software
Microsoft Word Microsoft Excel Microsoft Powerpoint Internet / E-mail
Ohter  
Others
Do you plan to study at a higher level?   Yes,when   No
If you plan to study Please specify   Bachelor ‘s Degree   Master's Degree Ph.D.
Have you ever been discharged from employment because your conduct or work was not satisfactory?
  NO   Yes. Please specify  
Have you ever been arrested and convicted of crime?
  NO   Yes. Please specify  
Do you have any physical handicaps, chronic diseases, or other disabilities?
  NO   Yes. Please specify  
Are you available to travel upcountry?
  Yes   No. Please specify the reason  
Are you available to travel foreign for 2-7 days ?
  Yes   No. Please specify the reason  
Can you provide guarantee ?
   Yes   No  
How to get a job from any source ?
INTERNET Website   Announcement of the company's website.
Employee. Name Department Parties  
Other  
Have you ever applied our group within this year ? Yes No
Reference Persons
1. Name   Occupation   Mobile Phone  
Address   Tel.Home  
2. Name   Occupation   Mobile Phone  
Address   Tel.Home  
Additional information you wish company know more
 
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