For Official Use Format: EMS/EAF

R S N K Revision: 2.1

BORANG PERMOHONAN KERJA

EMPLOYMENT APPLICATION FORM
GAMBAR TERBARU
(TIDAK DIKEMBALIKAN)
JAWATAN DIPOHON :
POSITION APPLIED RECENT PASSPORT-SIZED
GAJI DIJANGKA : PHOTOGRAPH
EXPECTED SALARY (NON RETURNABLE)
MAKLUMAT PERIBADI / PERSONAL PARTICULARS

NAMA :
NAME
ALAMAT :
ADDRESS

TARIKH LAHIR : NO. K/P. :

DATE OF BIRTH NRIC
WARGANEGARA : NO. TEL. (RUMAH) :
NATIONALITY TEL. NO. (HOUSE)
TARAF PERKAHWINAN : (PEJABAT) :
MARITAL STATUS (OFFICE)
E-MEL : (BIMBIT) :
E-MAIL (MOBILE)
TAHAP KESIHATAN : JANTINA :
HEALTH STATUS GENDER

MAKLUMAT KELUARGA / FAMILY PARTICULARS

NAMA SUAMI / ISTERI : NO. TEL. :

NAME OF SPOUSE TEL. NO.
PEKERJAAN : SYARIKAT :
OCCUPATION COMPANY
BILANGAN TANGGUNGAN :
NO. OF DEPENDENTS

MAKLUMAT PENDIDIKAN / EDUCATIONAL QUALIFICATION

KELULUSAN AKADEMIK INSTITUSI MULA TAMAT KEPUTUSAN (PNGK)
ACADEMIC QUALIFICATION INSTITUTION FROM TO RESULT (CGPA)

KELULUSAN KHAS / PROFESSIONAL :

PROFESSIONAL / SPECIAL QUALIFICATION

ADAKAH TERIKAT DENGAN BIASISWA : YA / YES ORGANISASI :

ARE YOU BOUND WITH ANY SCHOLARSHIP ORGANISATION
: TIDAK / NO TEMPOH :
DURATION

PENGETAHUAN BAHASA / LANGUAGE PROFICIENCY

BAHASA PERTUTURAN PENULISAN PEMBACAAN NYATAKAN KEBOLEHAN
LANGUAGE SPOKEN WRITTEN READING EVALUATE YOUR ABILITY
BAHASA MELAYU
MALAY LANGUAGE F FASIH / GOOD
BAHASA INGGERIS
ENGLISH LANGUAGE S SEDERHANA / FAIR

K KURANG / POOR
 MAKLUMAT PEKERJAAN SEKARANG / CURRENT EMPLOYMENT DETAILS

NAMA MAJIKAN : TARIKH LANTIKAN :

EMPLOYER'S NAME DATE JOINED
JAWATAN SEMASA : GAJI SEMASA :
CURRENT DESIGNATION CURRENT SALARY

BOLEHKAH TM MENYEMAK BUTIR DIRI / GAJI : YA : TIDAK

DO YOU ALLOW TM TO VERIFY YOUR PERSONAL DETAILS / SALARY YES NO

PENGALAMAN PEKERJAAN / EMPLOYMENT HISTORY

JAWATAN NAMA MAJIKAN MULA TAMAT GAJI SEBAB BERHENTI
DESIGNATION EMPLOYER'S NAME FROM TO SALARY REASON FOR LEAVING

PENGALAMAN KHUSUS (BERKAITAN DENGAN JAWATAN DIPOHON) :

SPECIFIC EXPERIENCE (RELATED TO POSITION APPLIED)
MENGAPA ANDA MEMOHON JAWATAN INI :
REASON FOR APPLYING THIS POSITION

SEKIRANYA DITAWARKAN, BILA BOLEH MEMULAKAN TUGAS :

IF YOU ARE OFFERED, WHEN YOU CAN START WORKING
TEMPOH NOTIS DIPERLUKAN :
NOTICE PERIOD REQUIRED
ADAKAH ANDA MEMPUNYAI KENDERAAN : YA : TIDAK
DO YOU POSSES YOUR OWN TRANSPORT YES NO

RUJUKAN / PENGESAHAN DIRI (BUKAN KELUARGA) / REFERENCES (NON RELATIVES)

NAMA ALAMAT NO. TEL. JAWATAN TEMPOH KENAL
NAME ADDRESS TEL. NO. DESIGNATION PERIOD

ADAKAH ANDA MEMPUNYAI KELUARGA YANG BERKHIDMAT DI KUMPULAN TM : YA : TIDAK

DO YOU HAVE ANY RELATIVES WORKING WITH THE TM GROUP OF COMPANIES YES NO

NAMA : JAWATAN :
NAME DESIGNATION
HUBUNGAN : BAHAGIAN / ANAK SYARIKAT :
RELATIONSHIP DIVISION / COMPANY

PERNAHKAH MEMOHON APA-APA JAWATAN DI TM / ANAK SYARIKAT TM : YA : TIDAK

HAVE YOU APPLIED FOR ANY POSITION IN TM OR ITS SUBSIDIARY YES NO

JAWATAN : BILA : KEPUTUSAN :

POSITION WHEN RESULT

SAYA AKUI BAHAWA SEMUA KENYATAAN YANG DIBERI ADALAH BENAR DAN TEPAT. JIKA PALSU AKAN MENYEBABKAN
PERMOHONAN SAYA TERBATAL DENGAN SENDIRINYA ATAU JIKA TELAHPUN DITAWARKAN JAWATAN, PERKHIDMATAN
SAYA AKAN DITAMATKAN DENGAN SERTA-MERTA.
I HEREBY CERTIFY THAT THE PARTICULARS FURNISHED BY ME ARE TRUE AND ACCURATE IN EVERY DETAIL. IF EMPLOYED, IN THE EVENT OF
A DISCOVERY OF ANY MISREPRESENTATION OF ACTS OR INFORMATION, WILLFUL OR OTHERWISE I WILL BE SUBJECTED TO SUMMARY DISMISSAL.

TANDATANGAN / SIGNATURE TARIKH / DATE

 APPLICANT PERSONAL DATA CONSENT FORM (“Form”)

We, take our responsibilities seriously to meet our data protection obligation under the PDPA
and consistently comply with the relevant laws and our operating principles in all our activities.
We collect and process your personal data to manage the potential employment,
apprenticeship and internship relationship between us and you, the applicant.

The information you provide in your application will be used and processed by us or on our
behalf for purposes related to your registration of interest in current or future apprenticeship,
internship or employment with us and for the processing of your said application.

Unless otherwise defined in this Form, the italicized words used herein shall have the meaning
given to them in our Privacy Notice which can be found at
https://www.tm.com.my/Documents/TM%20Privacy%20Notice.pdf

By providing your consent to this Form, you attest that you have been informed about the
processing of your personal data and that you acknowledge that you have read and fully
understand our Privacy Notice and this Form, and hereby accept its terms, and provide your
consent voluntarily. In order to maximize your opportunities to work with us, you are
encouraged to keep the information provided to us up to date at all times at our TM Job Portal.
You are responsible for ensuring that the personal data provided to us is correct and true.
You also have the option to withdraw your consent anytime by writing to us.

I have read and consent voluntarily to the above.

………………………...............................................
(Signature)

Name :
(as per identity card/passport)

NRIC/ Passport No. :

Date :
 Authorization letter / Consent to Background screening

Declaration: I ________________________________________ hereby authorize Smart Screen Solution

Sdn. Bhd. or any of its affiliates, and any persons/agents or organizations acting on its behalf to
undertake research and prepare a report on me for the purpose of pre-employment screening.

The above-mentioned report may include, but not limited to, the following area: names and dates of
previous/current employment, work experience, workers compensation/claims, professional references,
criminal history records (from local, state, federal, international and other law enforcement agencies’
records), warrants records, motor vehicle records, educational verification, license verification,
bankruptcy/credit history, directorship information, civil cases and other public record information,
including media reports.

I, further authorize and give consent to any person, educational establishment, business entity
government department, any other credit reporting agencies like RAM Credit Information Sdn. Bhd,
CTOS Data Systems Sdn Bhd and CCRIS from Bank Negara that may have information relevant to the
above to disclose the same to Smart Screen Solution Sdn Bhd, including, but not limited to, any and all
public bodies, regardless of whether such person, business entity or government department compiled
the information itself or received it from other sources.

I, hereby release Smart Screen Solution Sdn Bhd and its agents, officials, representatives, or assigned
agencies, including officers, employees, or related personnel both individually and collectively, from any
and all liability for damages by me, or others on my behalf of whatever kind, which may at any time,
result to me, my heirs, family or associates because of compliance with this authorization for release
form.

Applicant’s Name: _________________________ Mobile Phone: ____________________

NRIC / Passport Number: ____________________ Date of Birth : ____________________

Current Address: __________________________________________________________________

_________________________________________________________________________________

Applicant’s Signature: ____________________ Date: ________________________

Can we contact your current employer? Yes _____ No _____ (If Yes, we will call you for a verbal confirmation
before proceeding)