背调信息收集表

背景调查信息表

Important Notice/重要声明:

Shinedo will always respect your privacy and keep all the information concealed. Unless enforced by law, the private information that provided by you and that obtained by Shinedo will be kept under secrecy and never be disclosed for any purpose other than employment screening.

您的个人隐私将始终获得尊重。除非有法律强制性要求, 您所同意提供的个人信息以及轩渡咨询(或其授权的机构)所获得的任何信息将予保密并且不得用于除证明您就职适宜性以外的其他任何目的.

Please ensure all question in this form are completed and answered correctly.

请确保此信息表中所有的问题已全部完成并准确回答。

Please provide your wet signature on the Declaration and Letter of Authorization. Please ensure signature dates are today’s date.

请在声明及授权书手写签字。请确保签字日期为当前日期。

Shinedo does not commit to only contact the provided contact person to conduct background screening. He/She will be contacted only when necessary.

轩渡咨询并不承诺只会与所提供的联系人完成背景核实。所提供的信息将作为参考.

Once Background Screening is completed, the report will be returned to the HR team forrecording.

在背景核实完成后，相关报告会交至人力资源部门存档。

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Personal Information/个人信息 *Position Applied(应聘职位)： *Name (in local language) 姓名： Date of Birth (dd/mm/yy) Gender(性别) *Types of Identity(Identity card/Passport) Nationality(国籍) *Identity Card No. In order for the Company to obtain a complete and accurate background history please provide full details below. 为便于取得完整并准确的背景历史，请详细填写以下资料. Have you lived or worked in the United States during the past 7 years? If US SSN: yes, Please provide your US Social Security Number, and if no, please indicate “no” in the space provided: 您是否在过去7年中在美国居住或工作过？如果是，请提供您的美国社会保险号。如果是否，请在右侧空白处写”No” Have you lived or worked in Canada during the past 7 years? If yes, Please Canadian SIN: provide your Canadian Social Insurance Number, and if no, please indicate “no” in the space provided: 您是否在过去7年中在加拿大居住或工作过？如果是，请提供您的加拿大社会保险号。如果是否，请在右侧空白处写”No” Have you lived or worked in Singapore during the past 7 years? If yes, Singapore Please provide your Singapore NRIC/FIN, and if no, please indicate “no” in NRIC/FIN: the space provided: 您是否在过去7年中在新加坡居住或工作过？如果是，请提供您的新加坡身份证号/新加坡外籍人员身份证号。如果是否，请在右侧空白处写”No” For PRC Candidates: Please attach a copy of your PRC ID card 中国大陆籍候选人：请附上身份证复印件 For Other Candidates: Please attach a legible copy of your passport which was used when travelling to China 非中国大陆籍候选人：请附上护照复印件 Note for Korean Residents/Citizens: In accordance with the Article 24 of the Personal Information Protection Act in South Korea, please DO NOT PROVIDE US WITH YOUR Korean Resident Registration Number (RRN) in any form of communication or documentation. 朝鲜居民注意/公民: 按照《个人信息保护法》第二十四条的韩国,请不要以任何形式为我们提供你的韩国居民登记号码(RRN)。

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Educational Qualifications

Please provide details of your completed top tertiaryacademicqualification(s).

Educational institutions will be approached to verify your qualifications. Indicate the exact name under which any education qualifications were attained. Please provide full and clear names and addresses for each institution attended. Do not use abbreviated terms or initials.

If you don’t have any tertiary academic award, please check this box: 如果您没有任何高等教育经历证书，请勾选此框: *College / University (1) *Year of Study (month/year) 就学时间(月/年) From To Full Time(全日制) College / University Address *Certificate Number *Type of degree attained *Major Is this qualification archived from aChinese-Foreign cooperationprogram? If yes, please fill out below: 所取得的学历学位是否为中外合作教育项目？如果是，请提供以下信息: ChineseUniversity Name 中国大学名称： ForeignUniversity Name: 外国大学名称： 3

Professional Qualifications/专业资质经历

Professional Qualification bodies will be approached to verify your qualifications. Indicate the exact name under which any professional qualifications were attained. Please provide full and clear names and addresses for each body attended. Do not use abbreviated terms or initials.

专业资质机构将会被联系以便求证您的专业资质经历。请提供完整并准确的专业资质证书名称，机构名称及地址。请不要使用缩写或简写。

If you don’t have any tertiary academic award, please check this box:

如果您没有任何专业资质证书，请勾选此框:请附上专业资质证书复印件 Please attach copies of your Professional Qualification Certificate Issuing Body Name: 机构名称: Qualification Awarded: 获得资质:Qualification ID: 证书编号:Year of Award: (month/year) 颁发日期: 4

Employment History/工作经历

If you do not have any working experience, please check this box:

如果您没有任何工作经历，请勾选此框: Please list details of your lastemployers. Please state your current or most recent employment. The employer will be contacted to verify your employment history. Provide full names, addresses and, where possible, the telephone number of the employer. Do not use initials or abbreviations.

请填写您最近段的工作经历.请提供您当前或者最近的雇用经历。此雇主将会被联系以便求证于您的雇佣经历。

请提供公司全称，地址以及，如可能，此雇主的联系电话。请不要使用缩写或简写。 1 *Company Name(公司名称) Company Address(公司地址): *Job Title(职位): Employee ID(员工号): Job Title(职位): *Branch / Department(就职部门): Dates of Employment(就职时间): From(从) *HR Information 人事部信息 Name(姓名): Contact Detail(联系电话及邮箱): *Supervisor Information 主管信息: *Colleagues information 同事信息 *Reason for Leaving 离职原因 Name(姓名): Job Title(职位): Contact Detail(联系电话及邮箱): Name(姓名): Job Title(职位): Contact Detail(联系电话及邮箱): Additional Remarks(补充说明): *Can we contact this employer immediately to conduct a Background Screeningnow? (Please ?):我们现在能否立即与此雇主联系并开展背景调查 (请选择) If no, please specify the earliest date we can contact this employer to complete a Background Screening 如否，请提供最早我们可以与此雇主核实的日期12/04/2016(DD/MM/YYYY) 5

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