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ApplicationForm AnnexD

The document is an application form for employment or promotion at PhilHealth. It includes sections for personal information, current position, and an authorization for background checks regarding the applicant's suitability for the position. The applicant agrees to confidentiality and waives the right to sue for information provided during the background check process.

Uploaded by

Aaron Dela Cruz
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96 views2 pages

ApplicationForm AnnexD

The document is an application form for employment or promotion at PhilHealth. It includes sections for personal information, current position, and an authorization for background checks regarding the applicant's suitability for the position. The applicant agrees to confidentiality and waives the right to sue for information provided during the background check process.

Uploaded by

Aaron Dela Cruz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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ANNEX D

APPLICATION FORM

Order of
Preference Item No. Position Title SG Department/PRO

Name

Present Position/SG

Present Employment Status

Present Department/PRO (Agency)

AUTHORITY TO CONDUCT BACKGROUND CHECKS


I hereby authorize PhilHealth to make inquiry about and receive information about my suitability
for employment/promotion. I give permission to persons contacted to provide such information.
Such inquiries may include, but are not limited to the quality and quantity of my work, work record,
qualifications, education, and disciplinary records. I hereby waive, release and agreed not to sue
any person or organization for any result of providing, obtaining or acting upon such information. I
understand that such information is sought with confidentiality, and I will not request copies of
such information. A copy of this authorization shall be effective as the original.
Signature

Date
Department/PRO

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