APPLICATION FOR EMPLOYMENT FORM

Please complete this form and attach copies of all your educational certificates, transcripts and testimonials. If
space on this form is insufficient, please attach as addendum.
ABOUT MYSELF
Position applied for: Full Name : Preferred Name :
Junior Backend Developer Dr / Mr / Ahmad Shaukie Bin Mohd Yatim Shaukie
Ms
Address Telephone No.
No11B Lot 626 Lorong Lembah 1 JLN Mat Raji Padang Jawa Office Home Mobile
40200 Seksyen 17 Shah Alam Selangor 01131370114

Age Date of Birth Country of Birth Ethnic Origin (Race) Religion

26 11-04-1997 Malaysia Malay Islam

Email Citizenship / NRIC Nationality Marital Status

shaukie.work@gmail.com No./FIN no. Malaysian Single
970411-10-6211
Passport number Passport expiry date
Emergency contact details other Name Relationship Number
than own Mohd Yatim Bin Egeng Father 0192567618
Emergency Native contact number: Name Relationship Number

National Service Liability Language Proficiency

Written & Spoken Spoken Only

ABOUT MY FAMILY
SPOUSE
Full Name * Employer’s Name * Occupation *
CHILDREN
Age Sex Date of Birth Name of School / Position of
Full Name * * * * Employer * Employment *

PARENTS / BROTHERS / SISTERS

Position of
Full Name * Age Name of Employer * Employment *
*
Mohd Yatim Bin Egeng 60 Proton Sdn Bhd Clerk
Salluah Nurzakiyah Binti Ahmad 54 Housewife
Muhammad Shaufie Bin Mohd 30 Sart Art Services Sdn Bhd Boss
Yatim
Nurshafiza Binti Mohd Yatim 28 The Dentist Hub Dental Assistant
Nursyauqina Binti Mohd Yatim 22 The Dentist Hub Dental Assistant

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 EDUCATIONAL PARTICULARS
School / Institution (Please attach transcripts and Date Qualification
certificates) Obtained
(Name in chronological order, schools attended from the Commenced Completed / Date
age of 12) Expected
Completion
High School Klang 2010 2015 PMR & SPM
UiTM Raub 2015 2018 3.2
UiTM Jasin 2018 2020 2.8

Other academic or professional qualifications (eg CPA, CA)

Institution Country Type of Date Qualified
Membership
Certified Professional Requirement Engineering - Malaysia CPRE-FL 2018
Foundation Level

EMPLOYMENT HISTORY
Company Start Date End Date Position Basic Salary Allowanc Reason(s
(dd/mm/yy) (dd/mm/yy) Held e (if any) ) For
Leaving
Open Architecture 2020 2021 Technical 2500 2500 Better
Solutions Analyst opportun
ity
Tiong Nam Logistics 2021 now Software 3500 4000 Better
Solutions Sdn Bhd Engineer opportun
ity

Have you any objection to reference being made to your

a) Past Yes No b) Present Yes No

Employers Employer

NOTICE PERIOD PRESENT SALARY EXPECTED SALARY

2 months 6000
4000
Please give details of two referees whom we may approach for references.
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 Referees
Full Name: Amir Arshad Bin Amir Full Name:
Zhafri
Designation: IT Application Designation:
Engineer
Organisation Name: Tiong Nam Logistics Organisation Name:
Solutions Sdn Bhd
Number of years worked together 1 year 6 months Number of years
worked together
Contact No.: 019-7716258 Contact No.:
Email ID: amir.arshad@tiongnam Email ID:
.com.my

Other Information
Do you presently suffer or have you ever suffered from any physical impairment Yes No 
or disease including mental illness, deafness, handicap or any pre-existing
mmedical
medical co====c?
condition?
If yes, please specify: _______________________________________________

Have you ever been dismissed or discharged from the service of any company? Yes No 

Have you ever been convicted in a court of law in any country? Yes No 

Have you ever been detained by the police or any government (other than for Yes No 
traffic
Violations or misdemeanors)?
Have you ever applied to our company before? Yes No 

Do you have any family / friends currently employed by IDC? Yes No 

If yes, please specify NAME / RELATIONSHIP:
__________________________
Are you currently serving any bond? Yes No 
If yes, please give details.

Have you ever been declared a bankrupt? Yes No 

Are you pregnant now? (Applicable to female applicants only) Yes No 

Have you served your National Service Liability? (For Singaporean Male Only) Yes No 
Have you servedstate
If exempted, yourreason:
National Service Liability? (Applicable to Executive
Vocation in the Army: Rank: Unit: Period of Service:
                  From: To:
           
Mobilisation code       Next-in-camp training      
name: Due Date:

Declaration
(1) I hereby give consent to my data being used for the purposes of recruitment and employment.
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 (2) I declare that the information provided in this application and the attachments (if any) is true and
correct to the best of my knowledge and that I have not wilfully suppressed any material fact. I
accept that if any of the information given by me in this application is in any way false or
incorrect, my application may be rejected, any offer of employment may be withdrawn or my
employment with the Company may be terminated summarily or I may be dismissed.

Signature of Applicant: Date: 8/02/2023

For Head of Department use only

Interviewed by: Date:

Hiring Status: Offer / KIV / Reject

Comments:

Position offered: Category: Exempt / Non- Grade /

Exempt Level:
Start Date: Probation: Salary:

Department: Supervisor: Cost Centre:

Reviewed by:
Division/ Date: _______________
Department

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