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Application Form for EC General Manager

NEA application form for position of COOP General Manager

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Republic of.the Philippines

National Electrification Administration
Quezon Citv
.COOPERATIVE:._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
NAME OF A P P L I C A N T = - - - - - - - - - - - - - - - - - - - - . - - - - - - .
(LAST)
(FIRST)
(MIDDLE NAME)

PERSONAL EXPERIE~E RECORD OF APPLICANT FOR POSITION OF COOP
GENERAL MANAGER
I.COMPLETE] City_ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ __ _ __ _ _ __
. ADDRESS:
Provincial-----------------,----------2. TEL/MOBILE NO.
E-MAIL A D D : - - - - - - -

3.BIRTH:
4.HE.IGHT:

Date

5. WEIGHT:

Place _ _ _ _ _ _ _ __ _ __ _ __ __
·6. MARITAL STATUS: _ _ __

7.NAMEOF SPOUSE: _ _ _ _ _ _ _ _ __ __ _ _ _ _ _ _ _ __ _ __
8. NO. OF DEPENDENTS:
9. MINIMUM SALARY EXPECTED:------ 10.Are you related to an Officer, Board Member or employey of the Cooperative? If "Yes",
please indicate nature and civil degree ofrelationship, either by consanguinity or affinity.
11. Indicate and attach as Annex "A" why you are interested in the ·position and why you believe
you a re qualified.
12. EDUCATION: Attach as Annex "B" record of educational attainment from high school to
college/post graduate indicating:
a) course or degree
b) school
c) inclusive years attended
d) whether graduated or not
e) licensure, if any.
13. SEMINARS A ITENDED: Attach as Annex "C" all seminars and special trainings attended
indicating a) title b) inclusive .dates c) sponsor of training d) place held.
14. EMPLOYMENT RECORD: Attach as Annex "D" re~ord of ENTIRE past employment and
show present employment indicating, among others the·following: a) inclusive dates b) name
and address of employer c) kind of business or organiza{ion d) exact title of position e) salary
or earnings f) number and kind of employees supervised by you, if any g) reason for desiring
t0 change employment h) description of duties and responsibilities.
15.· MEMBERSHIP IN CIVIC ORGANIZATION: Attach as Annex "E" record of past and
present membership in civic o,rganizations.
·
16. REFERENCES: Attach as Annex "F" list of three persons not related to··you who are in a
position to know your work. Indicate a) name b) address c) occupation ·or business d) number
of years of acquaintance.

Signature of Applicant Over Printed Name
NOTE: Please submit eleven (11) copies each of the above_mentioned requirements.
Submir or Mail to:
NATIONAL ELECTRIFICATION ADMINISTRATION
Attention: Institutional Development Department
~A Building, NIA Road, Government Center
Diliman, Quezon City
NIA Road, Government Center, Diliman, Quezon City, Metro Manila, Philippines
Tel. No. 929-1909 or 928~
0414 / E-mail Address: omdd_idd@yahoo.com

Revised 317/2014
 
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