6-1表一：《员工个人信息登记表》 6页

'附6-1：表一（保密/PRIVATE&CONFIDENTIAL）员工登记表StaffInformationSheet INSTRUCTIONS1.此表用于提供招聘者的基本信息，同时做员工信息备案。Thisformhasbeendesignedtoprovideuswithbasicinformationforeasyprocessingofyourapplicationforemploymentwithus.Italsoservesasourpersonnelrecordshouldyoubeemployed.2.所有相关信息必须填写完毕。Allrelevantpartsofthisapplicationformmustbecompleted.3.录用后，若发现本表中任何信息填写不实，金丝猴公司保留终止申请者应聘的权力。Jinsihoucorporationreservestherighttoterminatetheemploymentoftheapplicantifanyoftheinformationinthisapplicationformisfoundtobeuntrueafterengagement.4.如果您通过邮递方式递交申请表，请邮递到以下地址：Ifyouaresendingusthisformviapost,pleaseattentionitto:上海市浦东新区沪南路5100号；邮编：201317职位/Position:____________不填填写日期/Date:__Ⅰ个人信息/PERSONALPARTICULARS姓名(以身份证为准)NameasinNRIC:董雷永英文名字/EnglishName:照片PHOTO年龄/Age:26性别/Sex:男Male○女Female出生地/PlaceofBirth:河南省沈丘县付井镇出生日期/DateofBirth:1986.04.29国籍/Nationality:中华人民共和国身份证号/NRICnumber:护照号/Passportnumber:412728198604296850民族/EthnicGroup:汉政治面貌/politicalstatus党员婚姻状况/MaritalStatus:○未婚Unmarrie已婚Married○单身Single联系信息/Contactinformation目前居住地址/Residentialaddress:河南省沈丘县付井镇户籍所在地地址/HouseholdRegistrationaddress:河南省沈丘县付井镇邮箱/Email:dongleiyong@jinsihou.com.cn手机Mobilenumber:15039497669住宅电话/Residentialtelephonenumber:办公电话/Officetelephonenumber:03946169735 II.家庭信息/FAMILYPARTICULARS请提供您配偶，孩子，父母和兄弟姐妹的信息/PLEASEGIVEDETAILSOFYOURSPOUSE,CHILDREN,PARENTSANDSIBLINGS.姓名/Name与本人关系/Relationship所在地/locus年龄/Age:职业/Occupation单位/Company董卫海父子沈丘县付井镇50公务员付井镇镇政府詹秀丽母子沈丘县付井镇52务农王苏华夫妻沈丘县付井镇26务农III.联系人/亲戚—紧急情况下/CONTACTPERSON/NEXTOFKIN–INCASEOFEMERGENCY姓名/Name:董卫海关系/Relationship:父亲居住地址/Residentialaddress:河南省沈丘县付井镇住宅电话/Residentialtelephonenumber:办公电话/Officetelephonenumber:手机/Mobilenumber:18239430788邮箱/Email:IV.获奖、证书SCHOLARSHIPS/AWARDS/BONDS获奖时间/YearofAward证书/Certificate介绍/Description起始时间/StartDateofBond结束时间/EndDateofBondVI.专业会员/PROFESSIONALMEMBERSHIPS从/From(mm/yy)到/To(mm/yy)协会/社团/公司Association/Society/Company名称/PositionHeldTitelVII.计算机技能&其他技能/:COMPUTERLITERACY&OTHERSKILLS请填写优、好、一般、较差/PLEASEINDICATE：EXCELLENT,GOOD,FAIRORPOOR计算机(Computer)：Word:Excel:PowerPoint:数据库:速记/Shorthand（每分钟字数/wpm）：打字Typing（每分钟字数/wpm）：好 其他技能/Other：visio绘图、CAD绘图使用软件情况/Softwareapplicationsthatyouareproficientin:好VIII.外语技能/LANGUAGEPROFICIENCY请填写优、好、一般、较差/PLEASEINDICATE：EXCELLENT,GOOD,FAIRORPOOR语言、方言/Language、Dialects书写Written口头SpokenIX.兴趣/爱好HOBBIES/INTERESTS/GAMESX.教育或其他专业资质/EDUCATIONALANDOTHERPROFESSIONALQUALIFICATIONS若进入面试，则请附上您教育证书/副本/PLEASEATTACHYOUREDUCATIONALCERTIFICATES/TRANSCRIPTSIFYOUARESHORT-LISTEDFORTHEINTERVIEW.从/From(mm/yy)到/To(mm/yy)毕业院校/NameofInstitution学历/HighestQualificationsAttained主修/MajorXI.工作经历/EMPLOYMENTHISTORY请详细填写最新的工作经历/PLEASESTARTWITHYOURCURRENTORMOSTRECENTEMPLOYMENT.PLEASEUSEADDITIONALSHEET(S)IFSPACEBELOWISINSUFFICIENT.公司名称和地址/Name&AddressofEmployer周口入职/From(mm/yy)离职/To(mm/yy)月薪Current/LastDrawnMonthlySalary津贴和分红/Allowance&Bonus(ifany)2####职位JobTitle&工作描述/BriefDescriptionofDuties离职原因/Reason(s)forLeaving公司名称和地址/Name&AddressofEmployer入职/From(mm/yy)离职/To(mm/yy)月薪/Current/LastDrawnMonthlySalary津贴和分红/Allowance&Bonus(ifany) 职位JobTitle&工作描述/BriefDescriptionofDuties离职原因/Reason(s)forLeaving公司名称和地址/Name&AddressofEmployer入职/From(mm/yy)离职/To(mm/yy)月薪/Current/LastDrawnMonthlySalary津贴和分红/Allowance&Bonus(ifany)职位JobTitle&工作描述/BriefDescriptionofDuties离职原因/Reason(s)forLeaving其他//OTHER入职/From(mm/yy)离职/To(mm/yy)单位名称/WorkingUnit职务及主要工作/PositionandKeyResponsibilitiesXII.证明人、介绍人/CHARACTERREFERENCES如介绍人是您近期任职的公司同事,请尽量提供的证明人为人事部经理或者总经理姓名/Name公司名称和地址/Name&AddressofEmployer职位JobTitle地址/Address联系方式/ContactNo.XIII.申明/DECLARATION1.对于目前/以前雇主是否有反对意见？Haveyouanyobjectiontoreferencebeingmadetoyourpresent/previousemployer?Yes/No2.是否被之前雇主开除？Haveyoubeendischargedordismissedfromtheserviceofyourpreviousemployers?Yes/No3.是否有精神疾病，或身体残疾？Haveyoubeenorareyousufferingfromanymentaldisorderorphysicalimpairment?Yes/No4.在过去的6个月，是否有疾病？Haveyoubeenorareyousufferingfromanydisease/illness/majormedicalconditioninthelast6months?Yes/No5.目前是否在接受医疗？Areyoucurrentlyonanymedication?Yes/No6.是否有吸毒？Haveyoutakenanyillicitdrugs?Yes/No 1.是否在任何国家受到宣判或违反法律？Haveyoubeenconvictedinacourtoflawinanycountryordetainedundertheprovisionsofanywrittenlaw?Yes/No2.是否被告贪污？Haveyoueverbeendeclaredabankrupt?Yes/No3.是否在任何非上市公司的经营业务中占有股份？Doyouhaveanyshareinanybusinessundertakingotherthanthatinapublic-listedcompany?Yes/No4.是否为其他公司董事会成员，或受雇于其他公司？Areyouholdingadirectorshiporotherappointmentinanycompany?Yes/No5.是否与金丝猴公司或其分支机构的员工有亲属关系及结谊关系？Doyouhaveanyrelatives/friendsworkinginJinsihoucorporationand/oritssubsidiary?Yes/No6.以前是否应聘过金丝猴公司或者其分支机构？HaveyouappliedforanyemploymentinJinsihoucorporationand/oritssubsidiarybefore?Yes/No以上问题，若回答是，请在以下空白处提供详细内容。Ifyouranswertoanyoftheaboveisyes,pleasegivedetailsinthespaceprovidedoronaseparatesheet.1.2.3.4.5.6.7.8.9.10.11.12. ·我申明以上填写内容均为真实内容。Ideclarethatalltheinformationgivenhereinistrueandcorrect.·受雇用后，若发现表中内容不真实填写，或故意遗漏隐藏信息，雇主可以以此为理由，解除雇用关系或开除员工。IunderstandthatamisrepresentationoromissionoffactswillbesufficientcauseforcancellationofconsiderationforemploymentordismissalfromtheCompany’sserviceifIhavebeenemployed.·我明白填写该表并非确定雇用应聘者。IunderstandthatcompletingthisapplicationisnotapromiseofemploymentfromtheGrouporitssubsidiaries.·我同意金丝猴公司以及/或者其下属分支机构，在任何时候考核我所填写信息，并调查本人背景。IauthorizeJinsihoucorporationLtdand/oritssubsidiariestoconfirmanyofthestatementsaboveandalsogivethecompanytherighttoinvestigatemybackgroundatanytime.·我在此申明，此表，以及简历中填写全部信息均真实可信。Iherebydeclarethatallinformationprovidedinthisapplicationandontheattachedresumeistrue,completeandaccurate.·我明白提供不真实的信息可以导致雇主立即解除合同。Iunderstandthatthesubmissionoffalseinformationormisrepresentationinthisapplication,mayresultintheimmediateterminationofmyemploymentshouldIbeemployedbytheCompany.申请者签名：Signatureofapplicant:申请日期/DateofApplication:'