Did you reside or work abroad?

0%

List down changes in position/designation for the last 10 years up to the present

Have you ever been dismissed or forced to resign from a position?

25%

Professional References:(Provide five(5) non-relative character references)

50%

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Certificate of Employment

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Government ID's

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Others

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DECLARATION

I hereby certify that all information provided in this form is accurate and complete to the best of my knowledge. I understand that any misrepresentation and/or falsification of any fact may result in cancellation of my employment or immediate dismissal.

I recognize that in connection with my job application, I may be subjected to a background check and hereby authorize the same.

NOTICE OF CONSENT AND APPROVAL FOR EMPLOYMENT VERIFICATION

Employer Information (Please indicate ALL previous/present employers.)

In relation to my application for employment with Alorica, I authorize said Company and any of its third-party background check services provider (particularly: Comprehensive Credit Services Inc.) to verify or validate any or all information I have provided or will provide at a later date, including any or all documents I have submitted or will submit at a later date, related to my employment history and background.

I am executing this NOTICE OF CONSENT AND APPROVAL, willingly and voluntarily, without compulsion and intimidation from Alorica

, any or all information I have provided or will provide at a later date, including any or all documents I have submitted or will be submitted at a later date, related to my educational history and background.

I am executing this NOTICE OF CONSENT AND APPROVAL, willingly and voluntarily, without compulsion and intimidation from Alorica

Signature over printed name

WITH MY FULL CONSENT AND AUTHORITY

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