APPLICATION FOR EMPLOYMENT

Please fill up this form legibly, all details must be provided.

1. POSITION APPLIED FOR : Attach

EXPECTED SALARY : RM Photograph here
(Compulsory to Fill In) Or
NOTICE PERIOD : NRIC Photo Copy

2. PERSONAL PARTICULARDS
Full Name as NRIC :
Preferred Name :

Correspondence Address :

Post Code : Contact No.

Home Address :

Post Code : Contact No.

Email Address : Race :
NRIC No. (New) (Old) : (Malay/Chinese/India/Others)

Date of Birth :
Religion :
Citizenship : (Islam/Buddhism/Hinduism/Christianity/other/Not Applicable)

Income Tax No. : Age : Sex (M/F)

Bank Acc No. : EPF No. :
ASN No. : SOCSO No. :

3. FAMILY PARTICULARS
Spouse’s Full Name: IC No. (New) :
Occupation : IC No. (Old) :

Father’s Name : IC No. (New) :

Occupation : IC No. (Old) :

Mother’s Name : IC No. (New) :

Occupation : IC No. (Old) :

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 Please provide the following details of your siblings and children of all ages
Name & Address of Employer
Name Relationship Date Of Birth Occupation
(If Employed)

4. ACADEMIC AND PROFESSIONAL QUALIFICATION

Certificate/Diploma/
Name Of
Degree/Professional Qualification CGPA/Grade Year/Grade (For Company Use)
School/Collage/University
Attained

5. RAINING COURSES
Please provide details of any specialized training, knowledge or experience e.g. Apprenticeship and Practical
Training as part of university work, etc.
Name Of Program Conducted by Duration

6. PROFESSIONAL MEMBERSHIP/AWARD
Please indicate professional body memberships/awards relevant to the position for which you are applying.
Name of Professional Bodies Type of Membership Year

7. LANGUAGE PROFICIENCY
[Level of language] ‘E’ for Elementary, ‘I’ for intermediate and ‘F’ for fluent [Level]
Writing Writing
Malay Reading English Reading
Spoken Spoken
Mother Language/Dialects.
Malay English Mandarin Other:
(Please specify or Select one)

8. COMPUTER LITERACY
Please indicate types of programmed/software application

9. CAREER EXPECTATIONS
Please describe your career expectation and aspirations in:

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10. CURRENT EMPLOYMENT
Date Of Employment (For Company Use)

Company’s Name & Address

Telephone Number
Position Held
Job Function
Report to whom?
Who are reporting to you?
Starting Basic Salary
Current Basic Salary
Allowance/incentive/
commission payable, if any
Total Monthly Earnings
(Inclusive of allowance)
11. PAST EMPLOYENT
Date Name & Address Of Employer Position Basic Salary Reason For (For Company
From To Employer Contact Held Starting Last Drawn Leaving Use)

12. EXTRA CURRICULAR AND LEISURE ACTIVITIES

State participation in extracumicular activities, position of responsibility held and games player at school.
University and current leisure activities
At School At University Current

13. REFERENCES
Please list two personal referees who are not relatives

Name & Address Occupation Tel. No. Years Know

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14. OTHER INFORMATION
Have you ever been charged and/convicted in any criminal court of law? YES NO
(If yes, state position, date &name of company)
Have you any active interest in any business undertaking, including family business? YES NO
(If yes, please give details)
Have you or your immediate family (spouse, parents and children) any borrowings? YES NO
(If yes, please give details)
15. MEDICAL AND PHYSICAL STATU
Have you suffered from or are you current suffering from serious illness / pregnant? YES NO
(If yes, please provide exact details)

Are you suffering from any physical disabilities? YES NO

(If yes, please provide exact details)

I declare that the information given in this application is true and accurate. I understand that any
misrepresentation
Of facts give herein will be sufficient cause for dismissal from the company’s services if I have been employed.
Enclosed are copies of my education/professional qualification certificate/diploma/degree and/or appropriate
recommendation letters.

Date: Signature:

FOR OFFICE USE ONLY

SOURCE OF REFERRAL:
Newspaper/Company’s Website/Other (please specify)

Interviewed By : Date :
Comments :

Further Interviewed By : Date :

Comments :
Status : Successful/KIV/Rejected Position Offered :
Name of Company/Dept/Branch: Commencement Date :
Salary : Grade :

Recommended By : Approved By :

………………………………………………………………………………… …………………………………………………………………………………
(Signature) (Signature)
Name : Name :
Designation : Designation :
Date : Date :
Remark : …………………………………………………………………………………………. Remark : ………………………………………………………………………………………….

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