No.

13 Jalan Puteri 5/20, Bandar Puteri, 47100 Puchong, Selangor Tel: 03-8068 2300 Fax: 03-8068 2400 Website: www.msd.net.my / jobs.msd.net.my

STRICTLY PRIVATE & CONFIDENTIAL

EMPLOYMENT APPLICATION FORM

MSD GROUP OF COMPANIES MSD Digital Intelligence Sdn Bhd (761551-T) I-Fabulous Art Media & Event Sdn Bhd (904973-U) Ingeniworks Sdn Bhd (934957-K) Mutual Covergence Sdn Bhd (1000895-P) Intelligence Net Care Sdn Bhd (709524-D) Future Automation Services Sdn Bhd (762582-P) Nilai Lavenda Sdn Bhd (916760-M) PLEASE STAPLE A RECENT PASSPORT SIZED PHOTOGRAPH)

Please read the instruction cafefully: 1. This form is to be completed before interview session. 2. Do not leave any item blank. If it is not applicable to you, please indicate "NA". 3. Please attached a copy of your IC or passport showing all relevant details. 4. Please attached photocopies of all your educational certificates & your comprehensive resume during interview. POSITION APPLIED FOR Manager
PERSONAL DETAILS Full Name (as per NRIC) : Adisuwandi bin Abdul Gani Permanent Address: No 18B Jalan Drahman Keria, 96100 Sarikei

NRIC No Passport No Nationality

Home Tel Handphone Email

Correspondence Address: No 18B Jalan Drahman Keria, 96100 Sarikei

: 880502-52-5527 :: Malaysian : 084 - 653713 : 014 9923354 : adieabdgani@gmail.com

Date of Birth: 02 / 05 / 1988 Place of Birth: Tanjung Manis, Sarikei Sex: Male Female Religion: Islam Height/Weight:178 cm / 90kg Age: 25 years Race: Malay Marital Status : Single Married Divorced Separated Widowed No. of Child: N/A EPF No: 71826619 SOCSO No: N/A Incom Tax No: N/A Driving License: Yes No ; Class: A / B / C / D Bank: RHB Acc. No: 11111900026970 FAMILY PARTICULARS No Name 1 2 3 4 5 6 Abd Gani b Ali Salamah binti Dolah Salmiah Abd Gani Age 62 59 23 Relationship Father Mother Sister Occupation Pensioner Housewife Student Employer Name N/A N/A Universiti Pendidikan Sultan Idris

LANGUAGE PROFICIENCY (Please tick at the specified column) No Written & Spoken Fluent 1 Malay 2 English 3 Iban SKILLS (Please tick at the specified column) Skills (Computer/Professional/Others) Computer Pastry Making Horticulture Fluent

Good

Fair

Good

Fair

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EDUCATION BACKGROUND (List School,Institutions and Universities attended) Year Schools / Institutions / Univertsities Location From To 2007 2010 Universiti Malaysia Sarawak K. Samarahan 2006 2007 Labuan Matriculation College Labuan 2004 2005 SMK Bandar Sarikei Sarikei 2001 2003 smk Bandar Sarikei Sarikei 1994 2000 SK Agama (MIS) Sarikei Sarikei *Please attached copies of relevant certificates and transcripts

Qualifications Attained* Bsc (Hons) of Plant Science SPM (5A1 1A2 3B3 1B4) PMR (7A 1C) UPSR (4A 2B)

MEMBERSHIP OF PROFESSIONAL INSTITUTIONS OR SOCIETY Year Name of Institution or Society 2013 2010 2010 PI1M Kg Seberang Sarikei JKKK Jalan Keria Sarikei Alumni Pelajar Sains Tumbuhan UNIMAS

Membership No. 55 N/A N/A

Postion Held Gold Member Member Member

COURSE ATTENDED Year Name of Course 2013 2013 Entrepreneurship Course Graduate Employability Enhancement

Institution/College/University Centre for Modern Management (CMM) Centre for Modern Management (CMM)

PRESENT EMPLOYMENT Year From To

Name of Company / Telephone No.

Type of Industry/Business

Position Held

Oct-13 1 2 3 4

Oct-13 POPULAR BOOK CO. (M) SDN BHD (084342216) Areasof Specialization / expertise Current Salary (RM) : 577 Arranging books in a tidy manner Updating book stock with the latest one Assisst in any retailing job Expected Salary (RM): N/A

BOOKSTORE PART TIME R. ASSISSTANT Notice Period: N/A /month Current Benefits: N/A Bonus: N/A Allowances: N/A /month

5 Reason for Leaving: ________________________________________________________________ ________________________________________________________________ It was a part time job only, when the company held a bookfair at Sarikei. PAST EMPLOYMENT Year From To 2010 2010 2010 2006 2013 2013 2012 2006

Others; please specify: _________________________ _________________________

Name of Company / Telephone No.

Position Held

Last Drawn Salary (RM) 200 920 300 300

Reason for leaving

Self Business (Part Time) Centre for Modern Management (CMM) Self Business (Part Time) SMK Sg Paoh Sarikei

Pastry Maker Agri. Assisstant Aquatic Plant Seller G. Canteen Worker

N/A Contract Expired On Hiatus Further Studies

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EMERGENCY CONTACT No Name

Relationship

Address

Contact No.

Abd Gani bin Ali

Father

NO 18B Jalan Drahman Keria

019 8874053

2 REFERENCES No Name

Salamah binti Dolah

Mother

NO 18B Jalan Drahman Keria

084 653713

Address / Telephone Jabatan Pertanian Daerah Sarikei

Occupation

Period Known

Abd Rahman bin Osen

Pen Pegawai Pertanian

3 years

PI1M Kg Seberang Sarikei 2 Amirah Nurul Jannah Alwie OTHER RELEVANT INFORMATION (Have you ; if Yes please provide details) 1 Any physical disability or handicap? Yes No (If Yes please specify) Pen Pengurus 10 years

2 Suffered from any major/long illness and/or drug additions? Yes No (If Yes please specify)

3 Ever been hospitalised? Yes No (If Yes please specify)

4 Ever held any responsible position in a club, trade union or associations? Yes No (If Yes please specify)

5 Any friends or relatives working in this company or its subsidiaries? Yes No (If Yes please specify)

6 Ever applied to this company or any of its subsidiaries? Yes No (If Yes please specify)

7 Ever been a bankrupt? Yes No (If Yes please specify)

8 Ever been convicted of a criminal offence? Yes No (If Yes please specify)

9 Do you own a vehicle? Yes No DECLARATION (If Yes please specify)

I declare that the information given above is to the best of my belief, true and correct and that i have not suppressed any fact. I understand that any mispresentation or falisification of any fact will be sufficient cause for the cancellation of consideration for employment or immediate termination (if i have been employed).

Signature Date: 4 December 2013

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