PRIVATE & CONFIDENTIAL Validate Form

EMPLOYMENT APPLICATION FORM

INSTRUCTIONS
1. This form has been designed to provide us with basic information for easy processing of your application for employment with us. It
also serves as our personnel record should you be employed.
2. Please complete this form by sending to us a softcopy version.
3. All relevant parts of this application form must be completed. Please click on the “Validate” button on the top right hand corner of this
form after all relevant fields have been indicated.
4. Hyflux reserves the right to terminate the employment of the applicant if any of the information in this application form is found to be
untrue after engagement.
5. If you are sending us this form via post, please attention it to:
The Human Resource Manager, 80 Bendemeer Road, Hyflux Innovation Centre, Singapore 339949.

Position Applied For: Date of Application: (dd/mm/yyyy)

Electrical Engineer 05/04/2017

I. PERSONAL PARTICULARS

Title: Mr Name Order: <Last Name> <First Name> Gender: Marital status:
Single
Last Name: KELLALI Male Female

First Name: ID Type: ID No.:

Amine NRIC FIN 237863

Preferred Name/Known As Name: Passport No.: Work Permit No.: (If applicable)
Amine 143061403

Birth Country: Religion: Name in Native Script, if

Algeria Islam applicable:
Place of Birth: Date of Birth: (dd/mm/yyyy) Race:
Oran 29/05/1985 Others
Citizenship: Singapore PR: Date attained SPR Status (dd/mm/yyyy)

Algeria Yes No

Contact information (in Singapore)

Street: Block/No: Unit No:

Building Name (if applicable): Postal Code:

Mobile No.: Home Phone No.:

0774577140
Contact information (Overseas, for non-Singapore citizen or permanent resident)
Street: Block/No: Unit
UnitNo:
No:
04 Street Fouatih Ahmed (Bel-Air) Oran Alger 04 Stree
Building Name (if applicable): Postal Code: State/Province:
Fouatih Ahmed 31000
Country: Mobile No.: Home Phone No.:
Algeria 0774577140
Other Contact Information

Email Address: amynou31000@yahoo.com

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II. FAMILY PARTICULARS
Please give details of your immediate family members.

Last Name Date of Birth

Name
(Family First Name Relationship Nationality Occupation Company
Order (dd/mm/yyyy)
Name/Surname)
<Last First> KELLALI Mohamed Brother Algeria 06/04/1977 Engineer foreign company
<Last First> KELLALI Samira Sister Algeria 24/03/1978 Teacher SCHOOL

III. CONTACT PERSON / NEXT OF KIN – In case of emergency

Name:
Relationship: Friend
Habib
Street: Block/No: Unit No:
04 Street (Bel-Air) Oran 04
Building Name (if applicable): Postal Code: State Province:
bel houari houari 31000
Country: Mobile No.: Home Phone No.:
Algeria 0770249326
Email Address: Office Telephone No.:
habib.bouazza@hotmail.fr

IV. NATIONAL SERVICE (if applicable)

Service Status: Exempted

If exempted, state reason: age more thanThirty years old

Enlistment Date (dd/mm/yyyy): ORD (dd/mm/yyyy):
Rank at ORD: NS Status: Active Inactive
Next reservist date (dd/mm/yyyy):

V. SCHOLARSHIPS / AWARDS / BONDS

Year of Value Start Date of Bond End Date of Bond
Description (dd/mm/yyyy) (dd/mm/yyyy)
Award of Award

VI. PROFESSIONAL MEMBERSHIPS

From To
(dd/mm/yyyy) (dd/mm/yyyy)
Association / Society / Company Position Held

VII. COMPUTER LITERACY

Software applications that you are proficient in:
Microsoft Office (Word, Excel,PowerPoint).
Solid works

VIII. LANGUAGE PROFICIENCY

Please indicate Good, Fair or Poor

Language / Dialects Written Spoken

English Good Good

French Good Good

Arabic Good Good

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IX. HOBBIES / INTERESTS / GAMES

Travel
Sports
Reading
Internet
X. Movies
EDUCATIONAL AND OTHER PROFESSIONAL QUALIFICATIONS
Please attach your educational certificates/ transcripts if you are short-listed for the interview.

From To Name of Institution /

(dd/mm/yyyy) (dd/mm/yyyy)
Highest Qualifications Attained Discipline
Country
20/11/2005 20/09/2008 USTO University of Science and Diploma Electrical Engineering
Technology /Oran
06/12/2008 19/07/2010 USTO University of Science and Master Electrical Engineering
Technology of Oran
22/11/2011 17/11/2014 UFC ORAN Advanced Diploma English Language Studies

XI. EMPLOYMENT HISTORY

Total years of working experience: 6

Total years of relevant working experience: 4

(Please state your latest 3 employment with the most current one)

Name
B.E.E.T.B BATNA Country of Work: Algeria
of Employer
From To Current /Last Drawn AWS Bonus Any Allowances
(dd/mm/yyyy) (dd/mm/yyyy) Monthly Basic Salary (Months) (Months) Per Month

23/01/2011 12/06/2011 21,000.00 SGD

Job Title Engineer to Study and Monitor

Site Supervision.
Brief Description Development plans.
of Duties The compliance of the equipment by providing market. Check if it is
relevant to the
job applying for.

Reason(s) for I was looking for another opportunity

Leaving

Name
ALSTOM Country of Work: Algeria
of Employer
From To Current /Last Drawn AWS Bonus Any Allowances
(dd/mm/yyyy) (dd/mm/yyyy) Monthly Basic Salary (Months) (Months) Per Month

30/04/2012 16/06/2013 54,000.00 SGD

Job Title Test and Control Engineer

•Supervising teams of pre-commissioning

Brief Description •Insolation test of high voltage transformer and electrical switchgear.
of Duties •Checking and control the electrical wiring, updating the plan as built. Check if it is
•Preparing check list forms for equipment test. relevant to the
•Assist and manage with the energy team for the commissioning of electrical equipment. job applying for.

Reason(s) for end of project

Leaving

Name
Cital ALSTOM Country of Work: Algeria
of Employer
From To Current /Last Drawn AWS Bonus Any Allowances
(dd/mm/yyyy) (dd/mm/yyyy) Monthly Basic Salary (Months) (Months) Per Month

16/06/2013 02/04/2017 80,000.00 SGD

Job Title Electrical Engineer

Pg 3 of 7 Last Revised: 11 January 2017

 •Preventive maintenance of electrical equipment and transformers
•Control of maintenance procedures and visual inspection of High Voltage Substation and
Brief Description Substations Check if it is
of Duties relevant to the
job applying for.

Reason(s) for Routine

Leaving

XII. CHARACTER REFERENCES

Occupation Period Known
Name Relationship & Name of the (Years)
Email Address Mobile No.
Organisation
kelali mohamed Brother foreign company 30.0 kelali_mo@yahoo.fr 066198617

Bouazza Habib Freind Safir 12.0 habib.bouazza@hotmail.fr 0770249326

XIII. Additional Information

What is your expected monthly salary? 80,000.00

How soon can you join us? 25/04/2017

How did you learn about this position? Others Pls specify if Others: by Linked IN

XIV. DECLARATION

1. Have you any objection to reference being made to your present / previous employer? Yes No

2. Have you been discharged or dismissed from the service of your previous employers? Yes No

3. Have you been or are you suffering from any mental disorder or physical impairment? Yes No

4. Have you been or are you suffering from any disease / illness / major medical condition in the
Yes No
last 6 months?

5. Have you taken any illicit drugs? Yes No

6. Have you been convicted in a court of law in any country or detained under the provisions of any
written law? Yes No

7. Have you ever been investigated by Commercial Affairs Department (CAD), Criminal
Investigation Department (CID), Corrupt Practices Investigation Bureau (CPIB) or other Yes No
government investigation departments?

8. Have you ever been declared a bankrupt? Yes No

9. Do you have any share in any business undertaking other than that in a public-listed company? Yes No

10. Are you holding a directorship or other appointment in any company? Yes No

11. Are you holding any shares in Hyflux Ltd? Yes No

12. Do you have any family members/ relatives/friends working in Hyflux Ltd and/or its subsidiary? Yes No

13. Do you have any family members/relatives/friends working in (or being shareholders other than Yes No
in public-listed companies) entities competing directly or indirectly with Hyflux Ltd and/or its
subsidiaries, or transacting with Hyflux Ltd and/or its subsidiaries, and who are in positions
within these entities that can influence the said transaction(s) with Hyflux Ltd and/or its
subsidiaries?

Pg 4 of 7 Last Revised: 11 January 2017

14. Have you applied for any employment in Hyflux Ltd and/or its subsidiary before? Yes No

15. Have you been previously employed by Hyflux Ltd and/or in its subsidiary? Yes No

If your answer to any of the above is yes, please give details in the space provided below.

12. when i a arrived to the company i found a colleague by coincidence

• I declare that all the information given herein is true and correct at the point of application. Should there be a need to
change my declaration after employment with Hyflux, I undertake to inform HR immediately.

• I understand that a misrepresentation or omission of facts will be sufficient cause for cancellation of consideration for
employment or dismissal from the Company’s service if I have been employed.

• I understand that completing this application is not a promise of employment from the Group or its subsidiaries.

• I authorize Hyflux Ltd and/or its subsidiaries to confirm any of the statements above and also give the company the
right to investigate my background at any time.

• I hereby declare that all information provided in this application and on the attached resume is true, complete
and accurate.

• I understand that the submission of false information or misrepresentation in this application, may result in the
immediate termination of my employment should I be employed by the Company.

• I have read, consent and agree to the collection, use and disclosure of my personal data for the purposes listed and
in accordance with the terms as set out in the attached privacy policy.

Signature of applicant:

Kellali Amine

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 Privacy Policy Statement

This statement sets out the Company’s Privacy Policy and the practices that will be followed with respect to the
collection, use and/or disclosure of employee personal data. This statement is provided in accordance with the
Personal Data Protection Act (Act 26 of 2012) (the “PDPA”).

1. Personal Data

You hereby agree that the Company, its subsidiaries and associated companies (together, the "Group") may,
as your prospective employer, collect, store, process, disclose, access, review and/or use personal data
(including sensitive personal data) about you, whether obtained from you or from other sources, for the purposes
set out below and/or any other evaluative purposes and/or the purpose of managing and/or terminating your
employment with any company within the Group:-
(i) administering and maintaining personnel records;
(ii) paying and reviewing salary and other remuneration and benefits;
(iii) providing and administering benefits (including any applicable insurance and/or employee share
option plan);
(iv) undertaking performance appraisals and reviews;
(v) maintaining records for sickness, holiday and other absence, including maternity, childcare or
infantcare leave;
(vi) making decisions about your fitness for work;
(vii) providing references and information to future employers, and if necessary, governmental and quasi-
governmental bodies, including, the Inland Revenue and the Central Provident Fund Board;
(viii) providing information to current and/or future partners and/or purchasers of the Company and/or its
business and/or any company within the Group or any of their respective businesses;
(ix) maintaining medical and dental records, including information about your physical and mental health
or condition;
(x) disciplinary and grievance matters;
(xi) recruitment activities;
(xii) opening, maintaining and operating bank accounts and the carrying out of treasury operations;
(xiii) arranging key installation visits and work-related travel, including the arrangement of flights,
accommodation and visas, when necessary;
(xiv) facilitating the making and payment of claims and/or reimbursements, including payments by cheque,
bank transfers or other means;
(xv) carrying out billing, accounting, auditing and the maintenance of proper book-keeping to explain the
Company’s operations and business;
(xvi) tax filing purposes;
(xvii) the preparation of financial reports and disclosure of the relevant books, documents, records and
information (in hard or soft copy) to the auditors, where necessary; and
(xviii) if you are assigned by the Company to work in other companies within the Group in another country,
to comply with local legislation, including but not limited to local employment legislation and to apply
for visas/work permits.
(xix) There may be pictures and videos collected for the marketing and/or publicity purposes. If you do not
want your picture or video to be used, please contact dpo@hyflux.com

Pg 6 of 7 Last Revised: 11 January 2017

2. Data Quality
The Company will take reasonable steps to make sure that the personal data it collects, uses or discloses is
accurate, complete and up to date.

3. Data Security
The Company will take reasonable steps to protect the personal data it holds from misuse and loss and from
unauthorized access, modification or disclosure.

The Company will not keep personal data for longer than is necessary and will take reasonable steps to
destroy or permanently de-identify personal data if it is no longer needed.

4. Access and Correction

You are entitled to have access to the personal data about you that is in the possession or under the control of
the Company and information about the ways in which the personal data has been or may have been used or
disclosed within a year before the date of the request. This can be done by you making a written application to
the Designated Person (as defined below) requesting for any such information. The Company reserves the
right to charge a fee (representing its costs in administering your request) for supplying such information and
to refuse requests which, in its opinion, occur with unreasonable frequency.

The Company will also, where you have requested that it correct an error or omission in the personal data
about you that is kept with the Company, correct such data as soon as practicable and send the corrected
personal data to every organisation to which the personal data was sent before it had been corrected, unless
that organisation does not need the corrected personal data for any legal or business purpose.

The Company may however choose not to provide you with access to or correct such information, in
accordance with the exceptions under the PDPA. This would include cases where:

(i) The Company is satisfied on reasonable grounds that the correction should not be made;

(ii) The request for access is frivolous or vexatious or the information requested is trivial;

(iii) The personal data is related to a prosecution and all the proceedings related to the prosecution have
not been completed;

(iv) The personal data, if disclosed, would reveal confidential commercial information that could, in the
opinion of a reasonable person, harm the competitive position of the organisation; and

(v) The personal data was collected, used or disclosed for the purposes of an investigation and
associated proceedings and appeals have not been completed.

5. Transborder Data Flows

If your personal data is transferred to a country or territory outside Singapore, for instance, if you are assigned
by the Company to work in other companies within the Group in another country, or if the personal data is
required for supervisory, administrative or operational purposes in other companies within the Group, we will
ensure that the recipients thereof provide a standard of protection to your personal data so transferred that is
comparable to that which is provided herein.

6. Enquiries and Complaints

The Company has designated the person whose details are set out below as the person (“Designated
Person”) who will be responsible for ensuring the Company’s compliance with applicable data protection laws.
If you have any queries or requests or wish to make any applications concerning your personal information or
data, please contact the Designated Person :

DPO@hyflux.com

Pg 7 of 7 Last Revised: 11 January 2017