Application for Employment - Aventus Medical Care Inc.

Date of Application: _____________________________
Postion Applied for: _____________________________
Desired Salary: _________________________________
Availability for Employment: ______________________
The Aventus Way
� We Embrace Change
� We Commit to a Common
Vision
� We Commit to Patient-centered
Care
� We Value Our Unique
Responsibility
� We Have Passion for Excellence
� We Adapt and Excel
� We Perfect Our Craft
� We Evaluate and Act
� We Value Time
� We Work to Lead
HRD Aventus Medical
June 2011
Application for Employment
Welcome to Aventus Medical Care Inc.,
You are applying for an out-patient/clinic chain
dedicated to providing holistic corporate health
services through a network of wholly-owned clinic
facilities with professional and highly trained staff.
We are a Corporate Health Care Service Provider
company focused on occupational health, patient care
and productivity enhancing wellness.
Our sevice is professional and compassionate,
efficient and cost-effective with the patients' well-being
in mind above all else.
Mission
We at Aventus Medical Care, Inc. are devoted to
providing high quality, effective, and efficient clinic
services intended to improve the health and well-being
of the communities we serve. In doing so, we commit
to maintain the high standards of professional and
reliable clinic care services to meet the needs of our
clients.
Vision
Aventus Medical Care, Inc. aims to be the leading
and widely recognized clinic health care provider in
the country today. Through professional and
competent medical staff coupled with modern
technology and patient-centered services, Aventus
shall be the premier choice for clinic related services
in the community; at all times maintaining valued
partnerships with our physicians, improving the health
of our clients, ensuring the financial strength our
organization, and guaranteeing growth opportunities
for the future.

HRD Aventus Medical
June 2011
Personal Information
Last Name Given Name Middle Name Nickname
City Address:
Permanent Address:
Mobile Number: Landline Number:
Age: Date of Birth: Sex: Civil Status:
Height: Weight: Citizenship: Religion:
SSS Number: TIN Number: Philhealth Number: Pag-ibig Number:
Employment Data (Start with most recent job)
Company Name & Address Position Held Inclusive
Dates
Last Salary Reason for Leaving
Company Name & Address Position Held Inclusive
Dates
Company Name & Address Position Held Inclusive
Dates
Last Salary Reason for Leaving
Last Salary Reason for Leaving
Educational Background
Years Attended
School Name & Address (Post Graduate) From To College/Degree/Honors
Obtained
School Name & Address (Tertiary) From To College/Degree/Honors
Obtained
Year
Graduated
Year
Graduated
School Name & Address (Secondary) From To Honors Obtained Year
Graduated
School Name & Address (Primary) From To Honors Obtained Year
Graduated
Interest and Hobbies:
Special Skills:
Machines/Equipments you can Operate:
Computer Skills:
Other Information

Father:
Mother:
Siblings:
Children:
HRD Aventus Medical
June 2011
Trainings and Seminars Attended
Title Year Taken
Government Examinations Taken
Title Year Taken Result/ Rating
Family Data
Name Age Occupation
General Information
Have you been suspended, discharged, or forced to resign?
Are you involved or have been involved in any
administrative, civil, or criminal case?
Who referred you to Aventus Medical Care, Inc.?
(also indicate the position and division/department)
I hereby certify that my answers to the questions on this application form are true and correct to the best of my knowledge
and that the pre-employment physical examination requested by Aventus Medical Care, Inc. is to be made with my consent. I also
agree that the said questions and answers shall form as a basis of my employment and give Aventus Medical Care, Inc. the right to
check my former employers and secure additional information, if necessary. I herby release from all liability or responsibility all
persons, companies or corporations furnishing such information. I also agree to submit to such future examinations that may be
required by the company and that the foregoing questions, answers, and examinations may be used in whatever manner it may
desire.
References (excluding relatives)
Name Telephone # and Address Occupation
I further understand that should there be material misrepresentation on the above date, it may cause for my separation from
the service at any time during my employment.
____________________________________________________
(Signature of Applicant over Printed Name)