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Human Resources

Name – Surname
Date of birth	/ /
Place of birth
Military Service	Completed Not Completed
Marital Status	Married Single Widow
Children Amount
SSK Registry No

Home Address
Phone
Mobile Phone

Education

Work situation (starting from your last workplace)

Company Name
Address

Entry Date	/ /
Leaving Date	/ /

Duty
Salary
Reason for leaving

Company Name
Address

Entry Date	/ /
Leaving Date	/ /

Duty
Salary
Reason for leaving

Company Name
Address

Entry Date	/ /
Leaving Date	/ /

Duty
Salary
Reason for leaving

Company Name
Address

Entry Date	/ /
Leaving Date	/ /

Duty
Salary
Reason for leaving

Do you have any disability?	Do you have any continuous illness?	Do you have criminal record?	Do you smoke ?
Yes No	Yes No	Yes No	Yes No

OF THE PEOPLE THAT MAY GIVE INFORMATION ABOUT YOU (Excluding your relatives)
Name – Surname	Address	Phone

What kind of a job do you want in our company?
The salary that you request from our company
Is there any drawback for you to work shifted?	Yes No
Is there any drawback for you to work overtime?	Yes No
Any person you know working in our company	Yes No
Have you applied to our company before?	Yes No

My declarations in this work requisition are true. I declare that I will accept Laminet to dismiss me if any of these declarations is found to be wrong and that I will not request any right or separation pay.