Register - FWCMS

SELF EMPLOYED REGISTRATION

A.Detail Information As In Passport

First Name^*

NLN (No Last Name)

Middle Name

Last Name^*

Gender^*

Date of Birth^*

Height^*

Nationality^*

Country of Origin^*

Passport No^*

Passport Issued At^*

Passport Issued Date^*

Passport Expired Date^*

Passport File

(Image or PDF file not over 1MB.) ^*

B.Detail Information As In Visa

Visa Part

Visa No^*

Visa Issued At^*

Visa Issued Date^*

Visa Expired Date^*

Visa Entry Date^*

Visa Remark

Visa and Arrival Immigration Stamp

(Image or PDF file not over 1MB.) ^*

Stay Permit Part

Stay Permit Type^*

Stay Permit No

Stay Permit Issue At

Stay Pemit Issue Date

Stay Permit Remark

Stay Permit (If Any)

(Image or PDF file not over 1MB.)

C.Business and Education

Main Business Activity^*

Specific Business Activity^*

Specific Business Activity Detail^*

Start Business Date^*

Business Address

Business house no

Business street no

Business group no

Province^*

District^*

Commune^*

Village

Position Categories^*

Education Background^*

Certificate/Permit approving the business activity issued by competent authority^*

Patent Tax (If Any)

(Image or PDF file not over 1MB.)

D.Physical Aptitude Certificate

Issued At^*

Physical Aptitude Certificate

(Image or PDF file not over 1MB.) ^*

E.Contact

Mobile Phone

Country Code^*

Ex.Cambodia - 855

Phone Number^*

Ex.12XXXXXX

Other Phone

Country Code

Ex.Cambodia - 855

Phone Number

Ex.12XXXXXX

Current Address

House no

Street no

Group no

Province^*

District^*

Commune^*

Village

E-mail^*

Confirm Email^*

Password^*

At least 8 characters
Upper & lowercase letters
At least one number
At least one symbol
Not compromised in breaches

Confirm Password^*

Photo size 4cm width and 6cm height (Taken in last 6 months)

(Image or PDF file not over 250KB.) ^*

Residence Certificate issued by competent authority

(Image or PDF file not over 1MB.) ^*

I hereby declare that the information in this application and any attachments is true and completed. Providing false or misleading information may result in the Ministry of Labour and Vocational Training taking action to strike the applicant off the enrollment and to be faced with the law.

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