COMPANY’S LETTERHEAD

EMPLOYMENT REGISTRATION FORM

PERSONAL DETAILS
Job Applied for
Full Name (as in IC)
IC No.

Full Address

Date of Birth Age

Place of Birth Race
Gender Nationality
Contact No. (H) Contact No. (M)
E-mail Address
EPF Number Account Number
Highest Academic
Qualification
1.
Experience 2.
3.

FAMILY DETAILS
Marital status Single / Married / Others
Spouse’s Name
No. of Children
(if any)
Emergency Contact Name: Contact No: Relationship:

I verify that the above information is correct. I acknowledge that providing false information deliberately could
result in my dismissal.

Signature: Date:

FOR OFFICE USE

Date of Join REMARKS
Position
Branch