Are you willing and free to travel upcountry if company requires?*
Yes No
Have you ever been involved in or convicted of civil or criminal offense ?*
(Other than minor traffic violation)?
If yes , explain :
Yes No
Did you ever have any operations or any physical defects or have suffered during the last 5 years? *
If yes , explain :
Yes No
Have you ever been discharged by any company ? *
If yes , please specify Yes N