BORANG PERMOHONAN JAWATAN

JOB APPLICATION FORM

JAWATAN YANG DIPOHON
Position Apply


1. MAKLUMAT PERIBADI
Personal Particulars

NAMA PENUH (SEPERTI DI DALAM K/P)
Full Name (as in IC)

JANTINA
Gender
Lelaki Perempuan
Male Female
NO. KAD PENGENALAN
I/C No.

TARIKH LAHIR
Date of Birth
/ /
UMUR
Age

NO. TELEFON (RUMAH)
Telephone No. (Residential)

NO. TELEFON (BIMBIT)
Telephone No.(mobile)

ALAMAT E-MAIL
Email address

ALAMAT RUMAH
Correspondence Address

TARFA PERKAHWINAN
Marital Status
Bujang
Single
Berkahwin
Married
Duda / Janda
Divorced / Widowed


2. PENDIDIKAN (mengikut turutan terawal)
EDUCATION (in chronological order)

PENDIDIKAN RENDAH & MENENGAH
Primary & Secondary School
BULAN & TAHUN
Month & Year SIJIL YANG DIPEROLEHI
Certificate Obtained
Dari / From Hingga / To




PENDIDIKAN TINGGI UNIVERSITI /
KOLEJ
Higher Learning University / College
BULAN & TAHUN
Month & Year
IJAZAH / DIPLOMA / SIJIL YANG
DIPEROLEHI
Degree/Diploma/Certificate Obtained Dari / From Hingga / To




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3. PENGALAMAN KERJA (mengikut turutan terawal) Sertakan resume / CV
Working Experience (in chronological order) Please attach resume / CV

JAWATAN / NAMA MAJIKAN
Position / Name of Employer
BULAN & TAHUN
Month & Year
RINGKASAN JAWATAN
Brief description of position
GAJI
BULANAN
Monthly Salary
(RM)
SEBAB
BERHENTI
Reason for Leaving
Dari
From
Hingga
To







4. KEMAHIRAN BAHASA (Sila tandakan {} di kotak yang berkenaan)
Language Proficiency (please {} in the appropriate box

BAHASA / DIALEK
Languages / Dialects
PERCAKAPAN
Spoken
PENULISAN
Written
Cemerlang
Excellent
Baik
Good
Lemah
Fair
Cemerlang
Excellent
Baik
Good
Lemah
Fair
a. Bahasa Melayu
b. English
c.
d.
e.

5. MAKLUMAT TAMBAHAN (Sila tandakan {} di kotak yang berkenaan)
Additional information (please {} in the appropriate box

PERKARA
Item
YA
Yes
TIDAK
No
Jika Ya, berikan
maklumat
If yes, please give details
a. Pernahkah anda terlibat atau dituduh dalam mana-mana pertuduhan
sivil dan jenayah?
Have you ever been implicated or convicted in any commercial criminal or civil
law proceedings?

b. Pernahkah anda bergantung kepada apa-apa jenis dadah / alkohol?
Have you ever been dependent on any kind of drugs / alcohol?

c. Pernahkah anda mengidap apa-apa jenis penyakit kronik?
Have you ever had any chronic illness / disease?

d. Pernahkah mana-mana ahli keluarga anda mengidap apa-apa jenis
penyakit kronik?
Has any member of your family ever had any chronic illness / disease?

e. Adakah anda hamil ?(untuk calon wanita)
Are you currently pregnant? (for female candidates)

f. Adakah anda menganggotai mana-mana kelab / pertubuhan?
Are you member of any club / association?

g. Adakah anda mempunyai saudara mara / kenalan yang sedang
berkhidmat dengan SPAN?
Do you have any relative/friend currently working in SPAN?



6. ORANG YANG BOLEH DIHUBUNGI SEMASA KECEMASAN
Person to contact in case of emergency

NAMA
Name
NO. TELEFON
Telephone No
ALAMAT EMAIL
Email Address
PERHUBUNGAN
Relationship
1.
2.



7. PENGAKUAN
Declaration

Saya dengan ini mengaku bahawa maklumat yang diberi oleh saya di dalam borang ini
adalah betul dan tepat di dalam pengetahuan saya. Saya memahami dan menerima jika pada
bila-bila masa selepas pelantikan saya, didapati ada mengemukakan maklumat palsu di
dalam borang ini termasuk menyembunyikan maklumat berkaitan, SPAN mempunyai hak
untuk menamatkan perkhidmatan saya.

I certify that the information given by me in this form is correct and accurate to the best of my knowledge. I fully
understand and accept that if at any time after my employment, it is found that any false declaration has been made
in this form including withholding of any relevant information, SPAN has the absolute right to terminate the
employment forthwith.





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Tandatangan Pemohon Tarikh
Applicants signature Date