Regency company limited




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REGENCY COMPANY LIMITED

28B/296, Mao Tse Tong Boulevard, S.K Tomnoubteouk, Tel : (855) 23 424 555

Khan Chamkamon, Phnom Penh, Kingdom of Cambodia. Fax : (855) 23 424 111

Email: admins@regency.com.kh




Application For Employment




Position applied for:………………………………………

Expected salary: ……………………………………………………

1. Personal Data

Name:…………………………………………………………… Sex:………….. Date of Birth:.………………….……….

Place of Birth:….………………………………………………………………………..………………….………..…………...

Nationality:……….………………………….…..………………………………………………………………………....……..

Present Address:…………..…………………………………………….…………………………………………….………….

………………………………………………………….……………………………………….…………………….…………………

Telephone number:…………………………………………… Email address:…………….………………………………
In case of emergency, notify:

Name:……………..…………………….………..……...…….. Relationship:………………….…………..…….…………

Address:………………….……..…………………………………………………………..………………….……………………

………………………………………………………..…………………………………………………………..………….…………

Telephone number:………..……………………..……………………………………………………………………….….…

Family:

Are you married? YesNo

If Yes, Do you have a legal marriage certificate? Yes No

Spouse’s Name:……………………………..……………………………………………………………………….……………

Occupation:…………………………………………………………………………………………………………….……………

Company’s Name:…………………………………………………………………………………………………….…………..

Number of children:………………………………………….………………………..…………………………………………

If No,

Father’s Name:…….…………………………….………… Occupation:……….…………………….…………………….

Mother’s Name:………………………………………..…… Occupation:…………………..………………………………


2. Formal Education

Circle highest grade complete Elementary High School College/University

1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8

List schools attended beginning with High School, including Technical Schools and other special training



Level of School

Name of School

City/ Province/ Country

Major/ Minor

Degree

or Certificate

High School/













Secondary

School













College



























Other























































































  1. Other Trainings

……………………………………………………………………………………………………………………………….……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………4. Special Interests

Hobbies or Activities

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5. Employment

List past two (2) employers or voluntary assignments beginning with the most recent.



Name of Organization/Company 1

Date Employed

Base Salary

Other Compensation




Month/ Year

(U.S. Dollars)

(Overtime Commission, etc.)




From:…………….

Start:……………. / Month

………………………




To:………………..

Ending:…………. / Month

………………………

Address:……………………………………………………………………………..…………………………………………………

Contact Number..………………………………………………………………………………………………………………..…

Position(s) (Title) Held:………………………………………………………………………………………………………..…

Describe your duties:………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………

Supervisor’s Name:………………………………………….. Supervisor’s Title:…………………………………………

Reason for Leaving:………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………




Name of Organization/Company 2

Date Employed

Base Salary

Other Compensation




Month/ Year

(U.S. Dollars)

(Overtime Commission, etc.)




From:…………….

Start:……………. / Month

………………………




To:………………..

Ending:…………. / Month

………………………

Address:……………………………………………………………………………..…………………………………………………

Contact Number..……………………………………………………………………………………………………………………

Position(s) (Title) Held:…………………………………………………………………………………….…..…………………

Describe your duties:……………………………………………………………………………………..…………..…………

……………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………

Supervisor’s Name:………………………….……………….. Supervisor’s Title:………………………….…………….

Reason for Leaving:……………………………………………………………………………………..…………………..……

……………………………………………………………………………………………………………………………………………



6. Language Ability:

Please rate yourself according to the definitions listed below:

0 - Poor 1 - Fair 2 - Good 3 - Fluent and Accurate

Verbal Written

Khmer ……………… ………………

English ……………… ………………

Chinese ……………… ………………

French ……………… ………………

Thai ……………… ………………

Other ……………… ………………

7. Additional Questions:

How did you hear about Regency Company Limited?

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Why are you applying for work with Regency Company Limited?

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Why are you applying for this position?

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How did you hear about this position?

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Why do you think your qualifications fit this position?

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What does this position mean to you?

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From your perspective, what are the challenges for this position? How would you deal with them?

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Where do you see yourself in next five years?

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Have you ever been dismissed or suspended from employment? Yes  No 

If Yes, give reasons:

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Do you have any close friends or relatives employed by Regency Company Limited? Yes No

If Yes, give Name, Position, Department:

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If offered assignment with Regency Company Limited, how soon will you be available to begin work?

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8. Reference

List those familiar with your capabilities in addition to the supervisors previously noted under employment (do not list relatives).



Name

Years

Known


Organization/Company

Position

Business Address

Phone

















1




























2




























3












I authorize the references listed above to provide REGENCY COMPANY LIMITED any and all information concerning my previous employment and any pertinent information that they may have. To the best of my knowledge, the answers to all of the questions contained herein are true and correct, and I have not knowingly withheld any information, which might in any way affect this application. I understand that any misstatements or omissions of material facts to this application may be cause for dismissal.



Signature of Applicant:…………………………………………………………… Date:……………………………………

Regency Company Limited

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