Application Form

Please Provide Complete and Accurate Information

Personal Information 个人信息

Name of Applicant 代朝镛/Dai Chao Gender 性别 male
姓名(中文/英文) Yong
Nationality 国籍 China ID Number 身份证号 510521199803222898
Position Applied for 申请职位 销售培训生 Department 职位所属部门 DI Sales Region Central
Email Address 邮件地址 2543855260@qq.co Registered residence 户籍地 四川/Sichuan

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Mobile 移动电话 18308311151 Interview Date 面试日期

Educational Background (start from the highest degree) 教育背景(从最高学历写起)

Duration (dd/mm/yy) School/University Degree Major
起止日期 (日/月/年) 学校 学位 专业
2021-09-02 2023-06-30 武汉大学 硕士/Master 机械

2017-09-07 2021-06-25 武汉理工大学 大学本科/Bachelor 车辆工程

Employment History (start with the most recent job) 工作经历（从最近的写起）

Duration (dd/mm/yy) Position Employer Reason of Leaving
起止日期 (日/月/年) 职位 单位名称 离职原因

Referee Information* Name Job Title

证明人信息 姓名 职位名称

Relationship Contact 手机(Mobile):

证明人关系 联系方式

Please choose the relevant answer according to your personal situation 请根据您的实际情况
对下列问题进行回答

1. Are you currently engaged in any other business or sideline work either as a proprietor, partner, officer, director,
trustee, employee, agent or otherwise? (您目前在其它单位担任任何职务或从事兼职工作，如所有人，股东，政府官员，
企业董事，企业托管人，雇员，代理或其它职务吗？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

2. Have you ever been arrested for or convicted of a criminal offence? (您是否被拘留过，或曾经被判有罪？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

3. Do you know anyone or do you have close relatives that work at the same or another Siemens affiliated company?
Do you have any special relationship (e.g family or intimate) with a Siemens manager who may directly or indirectly
influence the hiring decision?
(您是否认识员工或有亲属在同一或其他关联西门子公司中工作？您是否与西门子经理有关系(例如家庭或亲密关系)能够
直接或间接影响您的聘用决定?)
 Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

4. Have you signed Non-Competition Agreement with current employer? (您是否与目前的公司签订竞业禁止协议？)

Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

5. Do you have Training Bond with current employer? (您是否与目前的公司签订培训合同？)

Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

6. Have you signed Confidential Agreement with current employer? (您是否与目前的公司签订保密协议？)

Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

7. Do you or your close relative compete with Siemens on a self-employed or non-self-employed basis? (您或您亲属
是否自营的或非自营的与西门子竞争？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

8. Do you or your close relatives hold, directly or indirectly, interests in a competitor or an affiliated or an associated
company of Siemens or a company with which Siemens has business dealings? (您或您亲属是否直接或间接持有西
门子的竞争、关联、附属公司的权益或与西门子业务往来公司的权益？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

9. Do you have close relatives operate or engage in non-self-employed activities at a company with which Siemens has
business dealings ? (您亲属是否经营或受雇于与西门子有业务往来的公司 ？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

10. Do you have other situations that your personal interest may interfere with your business decision? e.g. current
member of E&Y audit engagement team for Siemens or Partner of E&Y?
(您是否有个人利益可能影响工作决策的其他情况 ？例如，目前是为西门子进行审计的安永工作组或者是安永的合伙
人？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

11. Have you ever worked for SLC or a branch or an affiliated or an associated company of Siemens before? (您是
否曾在西门子（中国）有限公司或其分公司、关联、附属公司工作过？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

12. Have you ever been engaged in any compliance violation (e.g. fraud, corruption or bribery, etc. ) during all your
former employments? (您是否在之前所有的雇佣关系中有过任何违反合规的行为（例如欺诈、贪污或贿赂等）？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)
13. Have you ever received any warnings or disciplinary sanctions during all your former employments? (您是否在之
前所有的雇佣关系中收到过任何警告或受到过任何纪律处分？)
Yes [ ] NO [ √ ]
If yes, please give details. (如回答是，请具体说明。)

Consent
同意书
I hereby consent to the collection, processing, use and analysis of my all above personal information (“Information”) by
Siemens China (“Company”), for the purposes of Recruitment, Compensation & Benefit Management, Employment &
Organizational Management, Individual & Company’s Security, Individual Development, Performance Management,
Compliance with Legal Obligations, Internal Audits/Investigations, Arbitrations/Litigations, People Analytics and any
other reasonable purposes that is relating to the performance of my employment relationship (if any) with the
Company(“Purposes”).
我在此同意西门子中国（“公司”）为招聘、薪酬福利管理、雇佣和组织管理、个人和公司安保、个人发展、绩效管理、遵
守法律义务、内部审计/调查、仲裁/诉讼、人员分析的目的以及其他与履行与公司的劳动关系（如有）相关的合理目的（“目
的”）收集、处理、使用和分析我的上述个人信息（“信息”）。
I understand and agree that the Company may collect the Information by asking me to fill in paper or online
forms/questionnaires and/or by conducting a basic internet search on publicly available information about me, and may
collect the Information through third parties or through software installed in the IT assets.
我理解并同意，公司可能通过要求我填写纸质或在线表格/问卷和/或通过在互联网上搜索关于我的公开信息的方式收集信
息，且可通过第三方或通过在 IT 资产上安装的软件收集信息。
I understand and agree that, for the Purposes outlined above, my Information (to the extent relevant to respective
Purposes) may be transferred to and/or shared with and/or disclosed to third parties, e.g. affiliated companies of the
Company, affiliated companies of Siemens Ltd., China, Siemens AG, affiliated companies of Siemens AG, the
Company’s agents, service providers, customers, suppliers, auditors, organizations specialized on people analytics,
governmental authorities, and judiciary authorities, etc. (“Recipients”). I further understand and agree that, the
aforementioned Recipients may be located outside the territory of the People’s Republic of China, and my Information
will only be transferred to such Recipients if the applicable legal requirements for such cross-border transfers are met
and complied with.
我理解并同意，为了上述所列目的，我的信息(在与各目的相关的范围内)可能被转移/转让给和/或共享给和/或披露给第三
方，例如，公司的关联公司、西门子（中国）有限公司的关联公司、西门子股份公司及其关联公司、公司的代理商、服
务提供商、客户、供应商、审计人员、人员分析机构、政府部门、司法部门等（“接收方”）。我进一步理解和同意，上述
接收方可能位于中华人民共和国境外，并且只有在所有适用于上述跨境转移的法律要求都得到满足和遵守后，公司才会
将我的信息进行上述跨境转移。
I understand and agree that, for the Purposes outlined above, and to the extent permitted by applicable law, the
Company may store my Information outside the territory of the People’s Republic of China, and may publicly disclose
the Information.
我理解并同意，为了上述所列目的，在适用法律允许的范围内，公司可以将我的信息存储在中华人民共和国境外，并且
可公开披露信息。
The Company will erase my Information if the retention of that Information is no longer necessary (1) for the purposes
for which they were collected or otherwise processed; or (2) to comply with legal obligations. The Company will take
proper organizational and technical measures to ensure the security of the Information.
若保存信息已不再为信息收集时的目的或为遵守法律义务所需要，公司将删除我的信息。公司将采取适当的组织和技术
措施以确保信息的安全。
I am aware that I may contact the Compliance department of the Company in case of any personal information protection
related questions, comments, concerns or complaints or in case that I wish to exercise any of my statutory rights relating
to personal information protection under applicable laws. More details on the Company’s privacy practices in relation to
the employees can be found in the Siemens Employee Privacy Notice.
我知晓，如果我有任何与个人信息保护有关的问题、意见、顾虑或投诉，或如果我有意行使适用法律下与个人信息保护
有关的法定权利，我可以联系公司的合规部。更多关于公司与员工有关的隐私实践可在西门子员工隐私通知中获得。
I hereby consent to the collection, processing, use, analysis, transfer, share, and public disclosure of my Information as
described above.
我在此同意以上描述的对我的信息的收集、处理、使用、分析、转移/转让、共享和公开披露。
Declaration 声明:
I hereby certify all of the statements made on the employment application form are true and complete and I
understand that omission or misrepresentation of any fact may result in refusal of employment or immediate dismissal
according to Labor Contract Law.
本人在此保证，本人在此职位申请表中填写的所有情况均属实和完整。由情况遗漏或失实可能导致求职申请被拒绝或根
据《劳动合同法》解除劳动合同，本人表示理解。
I recognize that in connection with employment with Siemens China I may be the subject of a background enquiry by
and I hereby authorize the same.
本人清楚并认可，在向西门子中国公司申请职位的过程中，本人可能成为相关背景核实的调查对象并且本人在此同意该
等事项。
I will immediately report any changes to the facts stated on this form to the Company.
如申请表中填写的情况有任何改变，我将立即告知西门子公司。
Other than manual signing, I agree this document can also be confirmed by me through affixing my electronic signature
in the form of electronic signature by issued digital certificate through Siemens electronic contract platform.
除手签形式外，本人同意本文件也可通过本人经由西门子电子合同平台凭所签发的数字证书以电子签名形式签字确认。

Candidate:
Signed (签名):