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Data Requested Brief Data Description
Previously employed by Chevron or affiliates? Indicate yes or no; if yes, include company name of employment - example: CTEP, COTL, etc.
Dates Previously Employed Date range of previous employment by Chevron
Previous EE Number Previous employee number from prior Chevron employment
Name of any Family employed by Chevron or affiliates? First and last names of spouse or children that are also an employee
Previous employment status Type of employment - Employee or Contractor
Personal Employee Information:
Salutation example: Mr, Mrs or Miss
Name in English "Format: Last Name, First Name Middle Name
For Expat, please provide the date shown in your passport"
Name in Thai Format: ชื่อ นามสกุล
Suffix (if any) This is an optional to indicate your suffix (if any) example: Jr, Sr., PhD
Citizen ID Your Citizen ID
Martial Status Your marital status - Single, Married, Divorced, Widow
Date of Birth Your date of birth (Format: DD MMM YYYY)
Nationality Nationality citizenship
Gender Your gender - Male, female or unknown
Country of Birth Your country of birth
Employee Bank Account No. Indicate bank name and 10- digit account
Religion This is an optional to indicate your religion
Passport Number Valid passport number (if any). This information is mandatory for an expatriate
Passport Country Issued Country that issued passport
Date Passport Issued Format: DD MMM YYYY
Date Passport Expires Format: DD MMM YYYY
Current Address/ Mailing Address in English:
Number, Building Name or Village Address number in Thailand. If you stay in an apartment, a condominium or a vilage, please also write down the name of the building/vilage also.
Road Name of road in Thailand, where your address locates
District Name of district in Thailand where your address locates
County/ Area Name of county or area in Thailand where your address locates
Province/ City Name of province in Thailand where your address locates e.g. Bangkok, Songkhla
Postal Code Postal code
Country Thailand
Prefix/Country Code International country code. Example: 66 = Thailand
Phone No. - Home Home phone # (incl. area code) e.g. 02 (BKK), 074 (SKL)
Phone No. - Mobile Mobile phone # (optional)
Permanent Address in English: = Home registration address (complete if different than Current Address above)
Number, Building Name or Village Address number and name of apartment, condominium or vilage (if any). If this information is the same as current address, you may skip it.
Road Name of road where your address locates
District Name of district where your address locates
County/ Area Name of county or area
Province/ City Name of province e.g. Bangkok, Songkhla or city where your address locates
State Name of state
Postal Code Postal code
Country Country where your adress locates
Current Address/ Mailing Address in Thai:
เลขที่บ้าน ชื่ออพาร์ทเม็นท์ คอนโดมิเนียม หรือหมู่บ้าน เลขที่บ้าน ชื่ออพาร์ทเม็นท์ คอนโดมิเนียม หรือหมู่บ้าน
ชื่อถนน ชื่อถนน
ชื่อแขวงหรือตำบล ชื่อแขวงหรือตำบล
ชื่อเขตหรืออำเภอ ชื่อเขตหรืออำเภอ
ชื่อจังหวัด เช่น กรุงเทพฯ สงขลา ชื่อจังหวัด เช่น กรุงเทพฯ สงขลา
รหัสไปรษณีย์ รหัสไปรษณีย์
Permanent Address in Thai:
เลขที่บ้าน ชื่ออพาร์ทเม็นท์ คอนโดมิเนียม หรือหมู่บ้าน เลขที่บ้าน ชื่ออพาร์ทเม็นท์ คอนโดมิเนียม หรือหมู่บ้าน
ชื่อถนน ชื่อถนน
ชื่อแขวงหรือตำบล ชื่อแขวงหรือตำบล
ชื่อเขตหรืออำเภอ ชื่อเขตหรืออำเภอ
ชื่อจังหวัด เช่น กรุงเทพฯ สงขลา ชื่อจังหวัด เช่น กรุงเทพฯ สงขลา
รหัสไปรษณีย์ รหัสไปรษณีย์
Emergency Contact: In case of emergency, who we can contact.
Given Name First Name
Middle Name Middle Name (if any)
Surname Last Name
Prefix/Country Code example: 66 = Thailand
Phone No. - Home Home phone # E.g. (02)545-5555. If the number is international, please also indicate the area code.
Phone No. - Mobile Mobile phone # E.g. (081)912-3456. If the number is international, please also indicate the area code.
Relationship to Employee example: parent, spouse, child, friend, etc.
Job History: List most recent job first.
Previous Job Start Date Format: DD MMM YYYY
Previous Job End Date Format: DD MMM YYYY
Position Title
Company Company previously employed by
Company Phone No. Company phone number including country code (optional)
Education List most recent education degree first.
Education Major Major degree that you graduated - example: Finance, Engineering
Education Minor If you also received a minor degree, you can indicate it as well.
Type of Degree Type of your degree, example: diploma; undergraduate = bachelor; graduate = masters; doctorate = PhD
Graduate Date Format DD MMM YYYY
Institution Name College/ University Name
GPA Rating your grade point average
Grading System The grading base that your institution uses to scale your GPA such as 4.00 basis or percentage basis
Honorary Description list any honorary distinctions, if applicable
Language Competencies:
Language Identify foreign language
Fluent Level of your fluent in that language - Good, Fair or Poor
Distinguishing Features:
Blood Group (Type) Your blood group. For example: O, O+, A, B, B-
DNA Tested Indicate if you have tested for DNA (yes/no)
Hair Color Your hair color
Eye Color Your eye color
Weight - in Kilos or Pounds Indicate number and scale in either Kilos or Pounds
Height - in Meters or Feet & Inches Indicate number and scale in either Meters or Feet & Inches
Doctor Name Name of your personal doctor (if any)
Doctor Telephone Your personal doctor's telephone number (if any)
Dentist Name Name of your personal dentist (if any)
Dentist Telephone Your personal dentist's telephone number (if any)
Mole Description & Location of your major mole
Birthmark Description & Location of your major birthmark
Tattoo Description Description & Location of your tattoo
Scar Description Description & Location of your scar
Next Physical Exam Date Your next physical check up date
Last Physical Exam Date Your previous physical check up date
Dependents: Dependents are your spouse and children.
Name of Dependent Name of your dependent (format: Last Name, First Name Middle Name)
Gender Gender of your dependent
DOB - Dependent Date of Birth for Dependent
High School Graduate? Yes or No (only child)
School Name Enter child's school name (if yes above)
Address - if different than employee Dependent's Address if different than Employee's
Relationship to Employee example: spouse, child, adopted child
Organizational Information
Original Hire Date Very first date hired by Chevron or affiliates. If contractor to employee, use date when employee status is effective.
Date Started (Transfer to Thailand) Date of subsequent hire (example: rehire - return to Chevron employment). For expatriate, this is the real transfer date to Thailand.
Payroll Country Country New Hire is paid out of
Ovetime Exempt or Non-exempt ? Exempt = no overtime; Nonexempt = paid overtime
Onshore or Offshore ? Indicate if new hire is ONshore or OFFshore
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