Gaming Employment License Application Form - Philippine Amusement And Gaming Corporation

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HRDD-GEAF-09-04.revised-102909
PHILIPPINE AMUSEMENT AND GAMING CORPORATION
A Global Corporation with A Global Mindset and A Filipino Heart
GAMING EMPLOYMENT LICENSE APPLICATION FORM
Print legibly. Mark appropriate boxes with "X"
Gaming License No. __________________
Indicate N/A for ALL spaces which are not applicable
use separate sheet for all information that cannot be accomodated in the spaces provided for
LICENSE TYPES AND FEES
OR No. ______________________________
(Choose only one registration type)
NEW
RENEWAL
REAPPLICATION
RECLASSIFICATION
Class A - Local Managerial
Class B - Local Supervisory
Class C - Local Rank & File
Registration Fee --- P5,000.00
Registration Fee --- P4,000.00
Registration Fee --- P2,200.00
Class D - Support Personnel
Class E - Foreign Managerial
Class F - Foreign Non-Managerial
Registration Fee --- P300.00
Registration Fee --- P15,000.00
Registration Fee --- P8,000.00
I. PERSONAL INFORMATION
POSITION APPLIED FOR
SURNAME
FIRST NAME
NAME EXTENSION (e.g. Jr., Sr.)
MIDDLE NAME
DATE OF BIRTH
PLACE OF BIRTH
PRESENT ADDRESS
SEX
Male
Female
Single
Widowed
ZIP CODE
Married
CIVIL STATUS
Annulled
Separated
TELEPHONE NO.
CITIZENSHIP
ACR NO. (Alien Cert. of Reg.)
PERMANENT ADDRESS
HEIGHT (m)
WEIGHT (kg)
ZIP CODE
TELEPHONE NO.
BLOOD TYPE
SSS / GSIS NO.
E-MAIL ADDRESS (if any)
CELLPHONE NO. (if any)
PAG-IBIG ID NO.
PHILHEALTH NO.
TIN
II. FAMILY BACKGROUND
SPOUSE'S SURNAME
NAME OF CHILD (Write full name and list all)
DATE OF BIRTH (mm/dd/yyyy)
FIRST NAME
MIDDLE NAME
OCCUPATION
SPOUSE'S EMPLOYER/
BUSINESS ADDRESS
TELEPHONE NO.
FATHER'S SURNAME
FIRST NAME
MIDDLE NAME
MOTHER'S MAIDEN NAME
FIRST NAME
MIDDLE NAME
III. EDUCATIONAL BACKGROUND
INCLUSIVE DATES OF ATTENDANCE
HIGHEST GRADE/
YEAR
SCHOLARSHIP/
(for undergraduates only)
NAME OF SCHOOL
DEGREE / COURSE
LEVEL/
LEVEL
GRADUATED
ACADEMIC HONORS
(Write in full)
(Write in full)
UNITS EARNED
(if graduated)
From
RECEIVED
To
(if not graduated)
ELEMENTARY
SECONDARY
VOCATIONAL /
TRADE COURSE
COLLEGE
GRADUATE STUDIES
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