|
|
|

Personal Information

Please fill in the mandatory fields marked with an asterisk (*).

Place of Birth*:

Cambodian

Street# *

House#*

Village*

Commune/Sangkat*

District/Khan/City *

Province/Capital *

Non-Cambodian:

Permanent Address*:

Cambodian

Street# *

House#*

Village*

Commune/Sangkat*

District/Khan/City *

Province/Capital *

Non-Cambodian:

Current Address*:

Cambodian

Street# *

House#*

Village*

Commune/Sangkat*

District/Khan/City *

Province/Capital *

Non-Cambodian:

Personal Information:*

Please fill in the mandatory fields marked with an asterisk (*).

Marital status*

Number of dependent*

Religion*

Race*

Personal information

For Casino Operations positions only:

Your Khmer Name (Cambodian only):

Father Status:

Mother Status:

Other information:*

Emergency contact:* Must be spouse, parent, sibling.

Emergency contact #1:*

Name*

Telephone Number*

Relationship*

Address*

Email*

Emergency contact #2:*

Name*

Telephone Number*

Relationship*

Address*

Email*

Embassy contact:* For non – Cambodian national only

Declaration

I, hereby declare that all information provided in this application form is, to the best of my knowledge, true, correct and complete. I understand that any false or wilfully suppressed information will render my application null and void; and if appointed, my contract will be terminated.

I understand and agree that any background and character inquiries requested by NagaWorld will be obliged and released without hindrance. The release is valid for all authorities.

Date

NagaWorld

We’ll reply as soon as we can
BOT
12:45
Hi, welcome to SimpleChat! Go ahead and send me a message. 😄
Vanchhai
12:46
You can change your name in JS section!