APPLICATION FOR EMPLOYMENT PHOTOGRAPH

Paste here a recent

REVERON CONSULTING SDN BHD passport size
(Co. No. 1086177-H) photograph which
provides a good
PERSONAL (*DELETE where necessary) likeness of you
Position Applied Marital Status (pls, tick (P)) Full Name (In Block Letter as per Identity Card)
0 Single 0 Widow *Mr/Ms/Mdm:
0 Married 0 Divorced

State/Country of Birth Citizenship Contact No. Postal Address

IRB Reference NRIC No. H/P:

House:
EPF Reference Email add: Permanent Address
New:
Date of Birth Height: cm
Age: Weight: kg
Language and Dialect Proficency (Please state Fluent/Fair/Poor)
Language/Dialect Speak Write Read
1)
2)
3)
4)
5)
6)
Particulars of Family
If married, particulars of Spouse Employer's
Full Name: Name: Address:
Job Title:

Children Sex/Age If in School or Employment If employed

Full Name Name & Address of School/Employment Job Title
1)
2)
3)
4)
5)
6)
Full Name of Father Job Title Employer's Name/Address

Full Name of Mother Job Title Employer's Name/Address

Brothers & Sisters Sex/Age If in School or Employement If employed

Full Name Name & Address of School/Employment Job Title
1)
2)
3)
4)
5)
6)
EDUCATION PARTICULARS
School Attended (in chronological order)
Date Highest Standard
School/Institution Town/City
Joined Left Attd. Passed

Academic Qualifications
Type of Qulification Year Grade
1)
2)
3)
4)
5)
Details of Further Education Course(s) being pursued at present
Name of School/Institution Address

Qualification or Certificate Date of

or Proficiency sought Commencement Expected Completion

Details of membership of Clubs, Associations, Societies, etc. (e.g. Scout, Red Cross Society, YMCA, Karate Club)

Details of leisure time hobbies, recreation, games, etc.

DETAILS OF PREVIOUS EMPLOYEMENT (in chronological order)

Last Date Reason for
Employer's Name/Address Job Title Drawn Leaving
Joined Left
Salary

Current Employment
Dated Gross Income Reason for
Employer's Name/Address Job Title
Joined Salary Leaving

Summary of Job Duties & Responsibilites

OTHERS INFORMATION
Do you have relatives or friends working for this Company? If yes, please state.
Position in the
Name Relationship Name of Company Location
Company
1)
2)
3)
Expected Salary If selected, when can you start work?

1) Have you been or are you suffering from any physical impairment or disease, e.g.
* YES / NO
Epilepsy, lameness, stammering?

2) Have you ever been charged with or convicted of a criminal offence in a Court of
Law in any country? If yes, please state date and details of offence: _____________ * YES / NO
______________________________________________________________________

3) Are you a bankrupt? * YES / NO

4) Are you pregnant? (for female applicants ONLY) * YES / NO

5) Have you applied for a job with us before? If yes, state date and position:
* YES / NO
______________________________________________________________________

6) May we make inquiries from your current employment? * YES / NO

7) Do you possess a valid driving license? If yes, state Class: _____________________

* YES / NO
Car/Motorcycle ownership, if yes, state: Model _______________ Year: ___________

8) Have you ever been dismissed or suspended from any position by your past/present
* YES / NO
employer?

CHARACTER REFERENCES (Name two persons (excluding relatives))

Full Name Full Name

Address Address

Contact No. Contact No.

Occupation Years known Occupation Years known

Other information which you consider important and helpful to us in assessing your suitability for the
appointment you are applying.

DECLARATION BY THE APPLICANT

I declare that the particulars in this application, *and the sheets attached hereto, are true in every respect.
I undrestand that if any of the particulars supplied by me are proved untrue, I am liable to be summarily
dimissed. I have not willfully suppressed any material facts.

__________________________________________ _______________________________
Signature Date
FOR OFFICE USE ONLY
Date of 1st Interview :
Interviewed By :
Result : 0 Suitable for Employment 0 KIV 0 Rejected
Comments: Strength

Weakness

Date of 2nd Interview :

Interviewed By :
Result : 0 Suitable for Employment 0 KIV 0 Rejected
Comments: Strength

Weakness

IF SUITABLE FOR EMPLOYMENT

Designation: Department/Outlet:
Date of Commencement: Company:
Basic Salary: Allowance:
Commission: Others:
Recommended by: Remarks if any:

____________________________________
Name:
Date:
APPROVAL BY DIRECTOR/PARTNERSHIP
0 Approved 0 Not Approved Comments if any:

____________________________________
Signature:
Date: