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Inquiry/Interview Sheet

PRA sheet for inquiry/interview

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Marketing Department
Client Relations and Program Development Division

INQUIRY / INTERVIEW SHEET
___
___

Walk-In Inquiry
Applicant ( ___Walk-in
___With Marketer)
___ Smile
___ Courtesy
___ Classic
___ Human Touch
Name of Marketer: _________________________
_________________________________________
___ Phone
___ Email

___
___
___

Potential SRRV Applicant
Potential Marketer
Just Inquiring

NAME: _______________________________________________________________________________
NATIONALITY: ___________________________DATE OF BIRTH: ________________________________
SEX: ___ Male
STATUS:
___Single
___ Separated/Divorced
___ Female
___ Married
___ Widow/Widower
ADDRESS:

_____ Local-based

_____ Foreign Based

Local: ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Telephone Number: ____________ Fax Number: ____________ Mobile Number: ____________
Abroad:________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Telephone Number: ____________ Fax Number: ___________ Mobile Number: _____________
Email Address: ____________________________________ Website: ____________________________
SOURCE OF INFORMATION:
___ PRA Website
___ Internet
___ Television
___ Radio

___ Marketer
___ Friends/Relatives
___ Brochures
___ Magazine/Newspapers

___ Embassies/Consular Offices
___ Foreign Institutions/s
___ Government Institution/s
___ Others (please specify)
__________________________

REMARKS/COMMENTS: __________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
SIGNATURE OF INTERVIEWEE: _____________________________________________________________
DATE: _________________________________________________________________________________
INTERVIEWER: __________________________________________________________________________
PRA-CR-FORM-0002

ISSUE NO: 0001

ISSUE DATE: JANUARY 2017
 
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