Questionnaire Date of filling in this form: / /

for mid-career recruiting Name:

(Rakuten, Inc. Development dep.)
Please complete and submit the written questionnaire to us by the deadline.
How did you get information on our openings? (please select all of the appropriate answers below)
Rakuten recruiting page Ad ( ) Employment agencyTechnology conference
Referral from employee (name of employee: ) Other ( )
What are your preferences on choosing the right company? (multiple answers allowed)
Influence on world Possibility of growing Development of services of a company
Salary/Benefits program Atmosphere in the company Attractiveness of Managers
Long-term employment Other( )
What are the services and divisions you would like to challenge in Rakuten?

Please tell us about the scope of your career search. (please choose one answer)
Considering only Rakuten
Considering other companies (Internet service company, SI, Consulting firm, other)
Please tell us your possible start date after receiving an informal appointment offer(choose one answer)
Immediately available After 1 month from receiving informal appointment After about 2 months from
receiving informal appointment other ( / / )
Please tell us about your income.
Base month salary ( / Month) Overtime payment ( / Month)
Other payments ( /Year) Annual bonus ( /Year)
Current annual income ( /Year) After tax-income ( /Year)
*A document stating your recent income such as withholding slip may be required in screening process, so
please answer as correctly as you can.
Please tell us your desired minimum annual salary after job placement.
Desired minimum annual salary ( ), including bonus
Do you know about the literary work of Hiroshi Mikitani, Rakutens CEO? If you do, please write down
your impressions of it.
Principles of SuccessI have read it I haven't read it
Opinion:
92 Rules of Success I have read it I haven't read it
Opinion:

Please tell us your health condition.

Do you have any issues concerning your health which could influence your work?
[ Yes / No ] If yes, issue( )

Have you ever had a long-term (more than 2 weeks) absence from work due to injury or disease?
[ Yes / No ] If yes, issue( )

1
 Questionnaire Date of filling in this form: / /
for mid-career recruiting Name:
(Rakuten, Inc. Development dep.)

In order for us to provide the necessary assistance after extending a job offer, please provide us with the
following information:
1. What type of Japanese visa (Status of Residence) do you have at this point?
Please check your passport and answer accurately. Ex. Engineer, Professor, Temporary Visitor, Tourist, Student,
Other ( )
Status of Residence:
2. When does your visa expire? Expiration Date(MM/DD/YYYY) : / /

[Notice of utilization purpose as per privacy policy] The personal information we

collect will be used in internal mid-career recruiting purposes only and held in the strictest confidence.

~Thank you for your cooperation!~