Personal History Form

PERSONAL HISTORY FORM

Please complete the form below to apply for a position with us.
A. PERSONAL DETAILS
Full Name*

First NameMiddle NameLast Name
Present Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Email Address
Applying for position
Position applying for (as mentioned in job post):*
Start date

MonthDayYear
Date of Birth

MonthDayYear
State of Birth
Marital Status
Spouse's detail
Name
Occupation
Telephone
Work Address
No. of Dependents
Relationship/s
Car
Next of Kin
Name
Relationship
Address
Telephone
Your Special Talent/Skills/Abilites?
Personal Goal in 5 years
Strengths

Educational Qualifications Post Primary (Be Specific)

	SECONDARY SCHOOL/INSTITUTION	FROM	TO	Lists Credits in 6 subjects (English and Mathematica Incl) e.g Maths A1.

University/Teritary Education

	Formal Training or Education (from Age 15)	FROM	TO	Specialty and Qualification Obtained	GPA

Professional Involvement

C. ENQUIRY ON POSITION BEING APPLIED FOR
What gaps in skill, knowledge or experience do you envisage you will have on the job being applied for?

MarketingManagementBusiness/EntrepreneurshipComputer/IT
Briefly explain, if applicable
Are you currently enrolled in any education programme?
When do you propose to complete?
Mention briefly, three key responsibilities & tasks you envisage you will perform on this job
State any past cognitive experience, skill, abilities etc you possess that will be useful for this job
State Expected Salary (Total package) including allowances
How soon can you start if employed?

	Name of Employer	Address of Employer	From	To	Salary per Annum	Exact Title of your Post	Type of Business	Name of Supervisor	No. and Kind of Staff you Supervised	Bonuses/Comission, if any

	Name of Employer	Address of Employer	From	To	Salary per Annum	Exact Title of your Post	Type of Business	Name of Supervisor	No. and Kind of Staff you Supervised	Bonuses/Comission, if any

	Name of Employer	Address of Employer	From	To	Salary per Annum	Exact Title of your Post	Type of Business	Name of Supervisor	No. and Kind of Staff you Supervised	Bonuses/Comission, if any
Service Quality
Overall Hygiene
Responsiveness
Kindness and Helpfulness

	Microsoft Word	Microsoft Excel	Microsoft Access	Programming: (Specify Language)	Corel Draw	Page Maker	Internet Application	E-mail	Web Based Programs
Poor 1
Average 2
Good 3
Very Good 4
Excellent 5

PERSONAL HISTORY FORM