FORM Document No.

: HRA/P101/F01
Revision : 01
EMPLOYMENT APPLICATION FORM Issue Date : 01/02/2016
Page :1/4

Affix recent
POST APPLIED FOR: ________________________________________________ photograph here
(non-returnable)

PERSONAL PARTICULARS
NAME NRIC NUMBER

ADDRESS TELEPHONE NUMBER:

HANDPHONE / RESIDENCE / OFFICE

NATIONALITY DATE OF BIRTH AGE SEX RELIGION

PASSPORT NUMBER RACE DIALECT MARITAL STATUS

APPLICANT SPOUSE
NAME OF SPOUSE NIRC NUMBER

NATIONALITY DATE OF BIRTH OCCUPATION

RACE DIALECT NUMBER OF CHILDREN

FAMILY INFORMATION
NAME RELATIONSHIP EMPLOYER

NEXT OF KIN
FATHER'S NAME AGE

MOTHER'S NAME AGE

EMERGENCY NOTIFICATION
NAME RELATIONSHIP TELEPHONE NUMBER

ADDRESS
 FORM Document No. : HRA/P101/F01
Revision : 01
EMPLOYMENT APPLICATION FORM Issue Date : 01/02/2016
Page :2/4

EDUCATION/TRAINING (A copy of each of your educational certificates must be attached)

STANDARD AT TIME DATES
SCHOOL/COLLEGE/UNIVERSITY ATTENDED
OF LEAVING FROM TO

ACADEMIC/VOCATIONAL/PROFESSIONAL CERTIFICATES DATE OBTAINED

ANY OTHER SPECIAL TRAINING/QUALIFICATIONS

HOBBIES CULTURAL AND SPORTING ACTIVITIES

 FORM Document No. : HRA/P101/F01
Revision : 01
EMPLOYMENT APPLICATION FORM Issue Date : 01/02/2016
Page :3/4

EMPLOYMENT HISTORY
DATES
NAME OF COMPANY POSITION HELD REASON FOR LEAVING
FROM TO

DETAILS OF DUTIES AND RESPONSIBILITIES OF LAST OR PRESENT POSITION

REMARKS

SALARY EXPECTATION: AVAILABLE DATE: __________________

DECLARATION

I, , hereby declare that the information I give herein is true and correct to
the best of my knowledge and belief.

I further declare that I understand that as the information given herein forms the basis of my
engagement by the company. I will be liable to instant dismissal should it be discovered that this
information is not correct or true in any particular point notwithstanding any provision in my contract of
service with the company.

DATE SIGNATURE OF APPLICANT

 FORM Document No. : HRA/P101/F01
Revision : 01
EMPLOYMENT APPLICATION FORM Issue Date : 01/02/2016
Page :4/4

FOR OFFICIAL USE ONLY

Interviewed by Position Signature Date

Interviewers’ Assessment : ____

Selected/Not Selected/K.I.V. by : Approved by :

Signature :______________________________ Signature :______________________________

Name :______________________________ Name :______________________________

Position :______________________________ Position :______________________________

Date : _____________________________ Date : _____________________________

Date to Commence Position/Department Starting Pay

Basic :

Allowance :

Others :