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Application For Employment: Q Q Q Q

This application is from Kent Noreen Modanza for the position of Medical Technologist at an unspecified organization. According to the summary, Modanza has a Bachelor's degree in Medical Laboratory Science from Liceo de Cagayan University. She has over 2 years of work experience as a Medical Technologist at Lance Diagnostic Center and Caraga Regional Hospital. Her duties included performing laboratory tests and procedures to assist physicians. Her most recent employment ended in February 2020. She is seeking a minimum salary of 15,000 for the new position.

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Eryn Hoover
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0% found this document useful (0 votes)
194 views6 pages

Application For Employment: Q Q Q Q

This application is from Kent Noreen Modanza for the position of Medical Technologist at an unspecified organization. According to the summary, Modanza has a Bachelor's degree in Medical Laboratory Science from Liceo de Cagayan University. She has over 2 years of work experience as a Medical Technologist at Lance Diagnostic Center and Caraga Regional Hospital. Her duties included performing laboratory tests and procedures to assist physicians. Her most recent employment ended in February 2020. She is seeking a minimum salary of 15,000 for the new position.

Uploaded by

Eryn Hoover
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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Date filed up

Attach recent photograph


April 11, 2020
Application for Employment

INSTRUCTIONS. Please answer each question clearly and


completely. Type entries & add extra sheet if needed. Read
carefully and follow all directions.
Preferred field of work Please confirm the vacancy you wish to be evaluated for by printing its position title below.
1. LABORATORY Position Title: MEDICAL TECHNOLOGIST
2. HEALTHCARE
Reason for wishing to be considered for the position at hand
Put my learning into practice to improve my capacity in serving the people and earn a living
Expected minimum salary How did you come to apply at PBSP?
15,000 q Walk-in q College Placement Office
q Ads q Referred by colleague
Family/Surname First Name Middle Name Maiden Name (if any)
MODANZA KENT NOREEN GORGONIO

(A) Address at which you reside at present (indicate since (B) Permanent residence (if different from A)
when)
ANHAWON, ZONE 9, BULUA, CAGAYAN DE ORO CITY SITIO BACUD, BRGY. LUNA, SURIGAO CITY
(since September 2018)

Telephone number Telephone number


880-8986 827-0021
Fax number Fax number
N/A N/A
E-mail address E-mail address
[email protected] [email protected]

EDUCATION
Give details in chronological order from High School. Include short courses and postgraduate studies in your professional/
occupation and related fields.
Name of school/college/university or Nature of course/studies/ Certificate/Diploma/
From To
equivalent, city/country specialization Degree obtained
June March Caraga Regional Science High Secondary education Highschool
2009 2013 School graduate
June March Liceo de Cagayan University Allied Health Sciences Bachelor in Medical
2013 2017 Laboratory Science
August Septemb Liceo de Cagayan University Medicine N/A
2018 er 2018

EMPLOYMENT RECORD
Starting with your present or most recent post, list in reverse order positions held. Attached additional pages if needed.
1 LANCE DIAGNOSTIC CENTER
Number and type of
Period Positions you have handled in the same organization before employees supervised by
you, (if any)
From To Starting Most recent
September February 29, Medical Technologist Medical Technologist 1
24, 2018 2020
Name and address of employer Name and title of supervisor
WEVINO A. PALAMINE
BRGY 18, CAPISTRANO-ABELLANOSA ST, CAGAYAN DE
ORO CITY

Brief description of your duties and responsibilities


Collection, processing and examination of samples namely blood, stool, and urine for specific tests in the following areas:
Hematology, Clinical Chemistry, Serology, Clinical Microscopy

Reason for leaving


End of contract

2 CARAGA REGIONAL HOSPITAL


Number and type of
Period Positions you have handled in the same organization before employees supervised by
you, (if any)
From To Starting Most recent
January June 26, 2018 MEDICAL TECHNOLOGIST MEDICAL TECHNOLOGIST (JO)
5,2018 (JO)

Name and address of employer Name and title of supervisor


CARAGA REGIONAL HOSPITAL MARITER J. SERING, MT IV
RIZAL STREET, BRGY. WASHINGTON, SURIGAO CITY
Brief description of your duties and responsibilities
Perform a variety of laboratory tests and procedures to assist physicians in
diagnosing, monitoring, treating and preventing disease. These are the areas: phlebotomy, blood banking, chemistry,
hematology, immunology, and microbiology
Reason for leaving
Postgraduate studies

3
Number and type of
Period Positions you have handled in the same organization before employees supervised by
you, (if any)
From To Starting Most recent

Name and address of employer Name and title of supervisor

Brief description of your duties and responsibilities

Reason for leaving

4
Number and type of
Period Positions you have handled in the same organization before employees supervised by
you, (if any)
From To Starting Most recent

Name and address of employer Name and title of supervisor

Brief description of your duties and responsibilities

Reason for leaving

5
Period Positions you have handled in the same organization before Number and type of
From To Starting Most recent employees supervised by
you, (if any)
PERSONAL DATA
Date of birth Place/Country of Nationality Age (as of last Residence Certificate No.
(day/month/year) birth FILIPINO birthday) To follow
29/08/1996 SURIGAO CITY 23 Date & place issued
July 2019
TIN SSS no. Phil Health no. Pag-Ibig no.
18-250790200-7
Tax status
q Single q Head of the Family q Married with __ dependent(s)
Sex Marital status q Single q Married q Single Parent
q Male q Female q Widow(er) q Separated
Dependent's name Date of birth Relationship Dependent's name Date of birth Relationship

Spouse name Father's name


BONIFACIO C. MODANZA
Birthdate Age Age Occupation
59 GOVERNMENT EMPLOYEE
Occupation Mother's name
EVA G. MODANZA
Name and address of company Age Occupation
50 TEACHER
Name of brothers/sisters
TENTH ANN G. MODANZA
JANUS MIGUEL G. MODANZA
JUNAS BONIFACIO G. MODANZA

Have you any near relatives working in another NGO? If so, give name, relationship and organization.
NONE

Contact person in case of emergency


Name: MR. AND MRS. BONIFACIO MODANZA Address:
SITIO BACUD, BRGY. LUNA, SURIGAO CITY
Contact Number: 09465249511/ 09076121094

Legal convictions: If you have ever been charged or found guilty of the violation of any law (other than minor traffic
violations), give details/ particulars.
Charge Date Where tried Conviction

Have you been involved in any administrative or civil cases? If yes, state nature

May we seek references from your present/most recent employer and your former employers and supervisors? If not, specify
exclusions. You may also add more references here, including name, occupation, relationship to you, address, telephone and
fax numbers.
Name Occupation Company Telephone no.
WEVINO A. PALAMINE, MEDICAL DOCTOR LANCE DIAGNOSTIC N/A
MD CENTER
CHERYL S. GOTINGA, OIC CARAGA REGIONAL N/A
MD HOSPITAL

Will you have or can you arrange return rights to your present employer?
Will depend on the employer

I certify that the statement made by me in answer to the foregoing questions are true, complete and correct to the best of my
knowledge and belief. I understand that any false statements or any required information withheld from this form may provide
grounds for the withdrawal of appointment or termination if an appointment has been accepted
Date April 12, 2020 Signature ____________________________________
QUESTIONNAIRE

Please give your reasons for wanting to join Philippine Business for Social Progress and why you are applying
for this post. Give any other relevant information (i.e. Technical knowledge, experience and personal qualities)
in support of your application, bearing in mind the job description and person specification for the post.

I am applying because I want to widen the horizon of my sworn duty in the service of the people by venturing
into a somewhat vaguely familiar field (I haven’t dealt much with sputum samples in my 2 years of actual work
experience aside from my internship days). I want to somehow refresh my learning from when I was still in
school and an intern so as to be equipped with knowledge in ALL areas covered by my course. I want to
gather experience in fields where a medical technologist can work in. I have worked in a hospital,in a clinic,
and now I would like to work with an NGO. I can grasp concepts pretty quickly and am easily trained. I can also
have experience in complying with DOH licensing requirements and am tech-savvy.

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