No: _/

(ZTEMYHR2012009)

PHOTO
EMPLOYMENT APPLICATION FORM
(Passport Size)
POSITION APPLIED

(A) PERSONAL PARTICULARS

FULL NAME (as per MyKad details):

PERMANENT ADDRESS:

CORRESPONDENCE ADDRESS:

HOME TEL NO.: MOBILE TEL NO.:

MYKAD NO.: AGE:

OLD NRIC NO (if any):

DATE OF BIRTH: GENDER:

RELIGION: RACE:

MARITAL STATUS: SINGLE MARRIED WIDOWED DIVORCED

PASSPORT NO.: NATIONALITY:

EPF NO.: SOSCO NO.:

INCOME TAX NO.: DRIVING LICENSE NO.:

E-MAIL ADDRESS: BANK NAME & ACCOUNT NO.:

We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)
HEIGHT: WEIGHT:

We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)
(B) FAMILY PARTICULARS

NAME OF FATHER: OCCUPATION: TEL NO.:

NAME OF MOTHER: OCCUPATION: TEL NO.:

NAME OF SIBLINGS (Brothers/Sisters) : OCCUPATION: TEL NO.:

1.
2.

3.

4.

5.

6.

7.

8.

NAME OF SPOUSE (Husband/Wife): OCCUPATION: TEL NO.:

CHILDREN NAME: DATE OF BIRTH: AGE:

1.
2.

3.

4.

5.

6.

(C) EDUCATIONAL BACKGROUND

DURATION
NAME OF SCHOOL/ COLLEGE/ UNIVERSITY ACHIEVEMENT
FROM TO

(D) LANGUAGE PROFICIENCY

LANGUAGES/ SPOKEN WRITTEN
DIALECTS EXCELLENT GOOD FAIR EXCELLENT GOOD FAIR

ENGLISH
BAHASA MALAYSIA
CHINESE - MANDARIN

We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)
(B) FAMILY PARTICULARS

We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)
(E) EMPLOYMENT HISTORY

DURATION BASIC ALLOWANCE & REASON FOR

EMPLOYER POSITION
FROM TO SALARY COMMISSION LEAVING

(F) OTHER INFORMATION PLEASE TICK (√) YES NO

1. ARE YOU IN GOOD HEALTH AND FREE FROM PHYSICAL AND MENTAL IMPAIRMENT OR DEFORMITY?

2. HAVE YOU EVER BEEN COMMITTED IN ANY LEGAL OFFENCE OR BRANKRUPTCY?

3. HAVE YOU EVER BEEN DISMISSED BY ANY PREVIOUS EMPLOYER?

4. ARE YOU WILLING TO WORK ON SHIFT?

(G) REFERRAL
NAME OF REFEREE DESIGNATION NAME OF EMPLOYER CONTACT NO.

(H) PERSON TO CONTACT IN CASE OF EMERGENCY

NAME: TEL NO (Home): (Mobile):

ADDRESS: RELATIONSHIP:

(I) PACKAGE & AVAILABILITY

EXPECTED SALARY (RM):

NOTICE OF RESIGNATION EXPECTED JOINING DATE:

PREFERABLE AREA, PLEASE TICK (√):

LOCAL (please specify):

OVERSEAS (please specify):

(I) RECOMMENDATION OF EMPLOYMENT

NAME OF INTRODUCER:

RELATIONSHIP: YEARS OF RELATIONSHIP:

***DECLARATION***
I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE AND THAT NO PERTINENT DETAILS HAVE BEEN
WITHELD. IF INFORMATION GIVEN ABOVE IS SUBSEQUENTLY FOUND TO BE INCORRECT OR INCOMPLETE OR
UNTRUE, THE COMPANY MAY TERMINATE MY EMPLOYMENT WITHOUT NOTICE OR COMPENSATION.

SIGNATURE DATE
We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)
(E) EMPLOYMENT HISTORY

We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)
FOR OFFICE USE:

(1) INTERNAL REFERRAL PROGRAMME

NAME OF INTRODUCER:

POSITION REWARD PLAN:

(2) INTERVIEW EVALUATION

NAME 1: NAME 2:

SUCCESS KIV REJECT SUCCESS KIV REJECT

NAME 3: NAME 4:

SUCCESS KIV REJECT SUCCESS KIV REJECT

(3) RECOMMENDATIONS FOR SUCCESSFUL APPLICANT

POSITION

DEPARTMENT/PROJECT

REPORTING DATE

REPORT TO

BASIC SALARY

ALLOWANCE/REIMBURSEMENT

OTHER BENEFITS

REMARKS

APPROVAL 1: APPROVAL 2:

HR DIRECTOR: L4/L5 MANAGEMENT:

DATE: DATE:

CHECKLIST
HR DEPT USE:- DATE
(Y/N)

1. Photocopies of Resume/Mykad/Payslip

2. Photocopies of Academic Certification/Transcript/Testimonial

3. Interview Assessment by Interviewer (Technical/Professional/HR)

4. Issue of Letter of Appointment & Letter of Pre-employment Medical Checkup

5. Send the Letter of Appointment & Letter of Pre-employment Checkup

6. Collect Duplicate copy of Letter of Appointment & Medical Check-up Report

We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)
We are committed to protecting your privacy in accordance with the Personal Data Protection Act 2010 of Malaysia (“PDPA”)