HR / JAF / 15-05-03C CONFIDENTIAL SULIT ii recent photog (Pleae erence Lekatkan gambar terbama (Sila caittan nama and 4dibelakang gambar) NAME OF APPLICANT : NAMA PEMOHON POSTFION APPLIED FOR : JAWATAN YANG DIPOHON PREFERED WORK LOCATION LOKASI PILIHAN HOW DID YOU COME TO KNOW OF THIS VACANCY? BAGAIMANA ANDA MENDAPAT TAHU MENGENAI JAWATAN KOSONG INI? NEWSPAPER EMPLOYMENT AGENCY PERODUA EMPLOYEE AKHBAR ‘AGENSI PERIAWATAN PEKERIA PERODUA WALKIN OTHERS (PLEASE SPECIFY) TEMUDUGA TERBUKA LAIN-LAIN (SILA NYATAKAN) NOTE/ NOTA 1, Pleat tn lak eter, Tk (9 one a appropiate. ‘Silat hu bese Tandon (/ ei petak ng berkenan 2. Cope of earSeae remeealssbuld be staced oh orm. ‘Selina i etn srat akan endllh lange brvaa borat. 5. Tho rgiala shuld be brought toe nterviow. ‘Sil aca henalick dita seme menghodr adap. 4. Pleas onal per ithe pe pove irre Sia unotan eras Beraingan ia range a tidak mencap. 5. Terma sven by applicants wl be teed as STRICTLY CONFIDENTIAL. Keserangen yang der oes penohon aan diye cara SULITPao on all Name = irene Ea Sea paced oma Penh Restenal actress ‘oma Redhanan Consponiecs Adis ‘Aerct Sat Mensur Dato ih = sc of Bik» Teeny Card No th air Teper Lair 1 Kad Pengenton Natonly = ‘Age Heise eign TEN owelRunaty ergongore rr Tagel ca | Ben ‘Giese ‘Maral Se + Race ‘Sen Diving Leese + Religion Tera Pershvinan | Danese Sentna Teen Memon ‘game PRC TTrer ety aera aati Dat OF ERT spate Relationship /Habungen ‘ame ‘Nana “oi Lair raion 2 ae 4 5 6 1 Faters Name Cccepation + Naa Bare Petetoan Motes Name vcapatin Nana oe PategoaPura gene eRe! ‘Please tck(/) in appropriate boxes ‘Sila tandekan (/) pada tempat yang berkenaan Language/Bahasa English/Bahasa Inggeris Malay/Bahasa Melayu a in-lain Poor | Good | Poor | Feir | Goos | Poor | Fur | Good Laman | Sederhana| Beit | Lamah | Sederhana| ‘Baik | Lemah_| Sederhana| ‘ait Written/Penulisan Spoken/Pertuturan Note: Pleas atch copes of elvan ceticntes Noe DATE TARIKEE HIGHEST QUALIFICATION OBTAINED EDUCATIONAL INSTITUTIONS TARA PENCAPAIAN TERTINGGI YANG RESULT/ KEPUTUSAN| PUSAT PENGAITAN wom | 10 | pissronent bart |_umvcca ‘PRIMARY SCHOOL, SEKOLAH RENDAM ‘SECONDARY SCHOOL: SEKOLAH MENENGAH ‘COLLEGE / UNIVERSITY ‘nelle Business Trade School KOLEWUNIVERSIT (Termasut Isnt Vokasionl) OTHER TRAINING ATTENDED: LATIHAN LAIN YANG DINADIRI eo Sennen er IPLemUCeae eee ety (Curent membership (Chbs / Profesional Bodies) ealianSeharang (Kelab / Badan Profesional)Note: List mos receat jb fist Nota: Senaraitanpekerjagn terbahara dahl ge Ue meres erent vw |e) ae | mae eee wet | atts | as | ome Ee ‘YES /7A NO/TIDAK |. Do you suffer fom any serious illnesses? ‘Adakah anda pernahdiserang penyatit yang seri? ee Sete 2. Ae you on any regular medication or une the eae fa specialist? ‘Adak anda di bawah ravatan dan / eau di bawah pemerhaton poker perubaten? = ainsaay 3. Do you have any physical disability / handicap? ‘Adatah anda terdapatkecacatan fetal? posteeee paseeey 4. 1F°Yes" co any ofthe above, please specify ‘ha "Ya" Saber keterangan yang lebih ant:Pao ees ns 1. Are you under contrat bond to seve aay organization? ‘Adakah anda mash di bawak Bontra /iton untuk eteri bagi mana-mana organisasi? 2, Have you aplia to Perodua previously? If co, state dates and position(s) applied for: [Adakah anda pemah memokon jaatan koxong di Perodua ja pernoh, nyatakan tart dan jawatan yan dipohon 3. offered employment, please sate: ka dtawartanpekaraan, sila nyatakan: 8) Period of notice you aro required to give prsent employer: Tempeh nts yang pera diberl kepada majikansekarang 1) Basic oxpected selary per month; RM Gof bulanan yang dipohon ©) Ober bene expected: ———— = Faeda tan yang diharepkan 4, IFYOU HAVE ANY RELATIVE WORKING IN THE PERODUA, PLEASE STATE, JIKA ANDA MEMPUNTAI SAUDARA-MARA YANG BEKERIA DI PERODUA, SILA NYATARAN: Name/Nana Relationship /Hubungan DepartmenDWvision/Jabarn/Unit. ‘5. Other information which s important to you and may be helpful tous = Makiunet lain yng boleh menyotong permohonan anda (CHARACTER REFEREES Please provide names & adaresses of two perions (nt relted) RUIUKAN Sa beri but burr mengenl ua orang (bukan sauder mara) Pall Nam=/ Name Penal Pall Name / Nama Penuh Address /Alamat ‘Address Alamar ‘TelNo.I No. Telefon TeLNo. No Telefon TeLNo./ Ne Telefon Ocoupation | Pekerjaan ‘Years known Bil Tahun Mengenali | Occupation Pekerjaan ‘Yeas known / Bit Tahun MengenalBee Race a tony Ne en zene 1. 1 +havefhave nt been dismissed from any employment because of misconduct, ‘Saya *permablidak pernahaiberhenikan kerja kerana sala lak 2. 1thavernave not been arested and convicted in any court of lw or detained under he provision of any writen lav Saya Ypemahfidet pernahdanghap dan djauhtan hukuman di dalam mana-mana mabkamah undong-undang ata dtahan dl bawah apa juga eruntkan wadang-undang. 3, 1 shavelhave not suffered any serious illness during the past fie (5) years and I *heveldo nochave ay pysial handicap, chronic diseases or cther disablement ‘Saya Yadafidak ada mengarlsebarang penyakit tend dalam Janghamast lina (5) tahun kebelakangan ni dan saya Yadatidat da menghidepi ‘pa jag penyakt, kecacatan ata lainlan ketdakmanpuan. 4. [thavemave not been declared a bankrupt and havefhave not any order made aginst me under the Bankrupt Oninsnce. Saya *pemabidk pernahdistharkan bantoap don tpernakhida pernah ditukum di bavah Ondinan Kebanghecpan 5, Thave® Ihave not been employed by Perodua before. Saya permab / tidak peruah beleria di Perodua sebelam * Delete where not necessary. + Poiong yang tidak berkenaan A HEREBY DECLARE THAT THE INFORMATION GIVEN BY ME IN THIS FORM IS CORRECT AND TRUE TO THE BEST OF MY KNOWLEDGE, TFULLY UNDERSTAND AND ACCEPT THAT IF AT ANY TIME AFTER ENGAGEMENT IT IS FOUND THAT A FALSE DECLARATION HAS BEEN MADE IN THIS FORM THE EMPLOYER HAS THE ABSOLUTE RIGHT TO TERMINATE MY EMPLOYMENT FORTHWITH. DENGAN INI SAYA MENGESAHKAN BAIAWA SEGALA KETERANGAN YANG TELAH SAYA BERIKAN DI DALAM BORANG IV ADALAM RENAR DAW BETUD. ‘SAYA BAIAM DAU TERIMA B&HAWA PADA SILA-BLA MASA SELEPAS SAYA DITERIMA BEKERI, KA DIDAPAT/SAYA TELAH MEMIERURAN KETERANGAD YANG PALSU DI DALAM BOBANG IM, PAK MALTKAN MEMPUNTAI BAK MUTLAK UNTOK MENAMATEAN PERKHIDMATAN SAYA ‘DENGAN SERTA-MERTA ‘SIGNATURE TANDATANGAN “DATE /naene FOR OFFICE USE ONLY / UNTUK KEGUNAAN PEJABAT SAHAJA, JOBTITLE ‘REQUISHTTONNO ‘SALARY ‘COMMENCEMENT DATE ‘BASE (DEPT/BRANCHD) DIVISION/ COMPANY ‘GRADE INDUCTION DATE REMARKS ‘APPROVED FOR EMPLOYMENT HEAD OF SECTION HEADOFDEPT, DeM7GM 7D /ED/SGM ‘SCMBMAM) NAMB: NAMB: ‘NAME: NAME: POSITION: PosTrioN: POSITION: PosrTioN: are: DATE: pare: DATE: i "HUMAN RESOURCES MANAGER: STATUS: 1 SUCCESSFUL /KIVIREECT