Last name (required)
Mother's last name (required)
First name (required)
Postal zone (required)
Place of birth (required)
Lives with.. (required)
---His ParentsHis familyFamily membersAlone
People who depend on you.. (required)
Civil status (required)
Affiliation to Social Security No
Has a driver's license (required)
Class and license number
Being a foreigner that documents allows you to work in the country
How do you consider your current health status? (required)
Do you have a chronic illness? (required)
In case you answered yes, which one?
Name and ages of children
Sibling name 1
Brother name 2
Brother name 3
Year of term
Secondary or Prevocational Name
Name of Preparatory or Vocational
Course or career
Languages that he masters
Name of the company
Initial monthly salary
Final Monthly Salary
Reason for their separation
Direct boss name
Direct boss position
Can we request reports from you?
In case of answering "No", reasons?
Time to meet him
How did you know about this job?
If answer "Other means", which?
has he relatives working in this company?
If you answer "Yes", mention them
Have you been entrenched?
If you answer "Yes", write down the name of the company.
Are you affiliated with a union?
If you answer "Yes", which one?
Do you have life insurance?
If you answer "Yes", what is the sum insured?
Are you willing to change your place of residence?
Date you could show up to work
Do you have other income?
If you answer "Yes", enter the monthly amount.
Your spouse works?
Do you live in your own home?
If you answer "Yes", write down the approximate value.
Do you pay rent?
Do you have your own car?
If you answer "Yes", write down the make and model :
Do you have debts?
If you answer "Yes", write down with whom and the amount.
How much do you pay monthly?
How much are your monthly expenses?