PRIVATE & CONFIDENTIAL

SULIT & PERSENDIRIAN

CCM GROUP
KUMPULAN SYARIKAT CCM
APPLICATION FOR EMPLOYMENT
PERMOHONAN UNTUK JAWATAN
Full explanations must be provided for all information required. Please provide
copies of relevant documents to support this application. Please bring along
original and copy of the following for interview: Identity Card, Latest Pay Slip,
Relevant Certificates, Photo and other relevant documents.
Keterangan penuh hendaklah diberi untuk informasi yang dikehendaki. Sila lampirkan salinan sijil
REMINDER yang berkaitan sebagai sokongan. Sila bawa dokumen asal dan salinan seperti berikut ketika
PHOTO
PERINGATAN temuduga : Kad Pengenalan, Penyata Gaji Terkini, Sijil yang berkaitan, Gambar dan lain-lain
GAMBAR
dokumen yang perlu.

This form should be completed fully.

Sila pastikan anda mengisi semua tempat kosong.

POSITION APPLIED FOR

JAWATAN DIPOHON

PERSONAL DETAILS
MAKLUMAT PERIBADI
Name (as in MyKAD)
Nama (seperti dalam
MyKAD)

MyCard no. Passport no.

Old NRIC no.
No. MyKAD (Non Malaysian)
No KP lama
No, Pasport

Correspondence address
Alamat Surat Menyurat

Permanent address
Alamat tetap

Resident phone no. Office phone no. Mobile no.

No. telefon rumah No tel pejabat No. tel bimbit
Height (cm)
Religion Tinggi Weight (kg)
Agama Berat (kg)

Date of birth Place of birth Age

Tarikh Lahir Tempat Lahir Umur
Race Email Address
Bangsa Alamat Email
Nationality Bumi / Non-Bumi Gender : Male / Female
Kewargenaraan Bumi.Bukan Bumi Jantina :Lelaki/Perempuan
Marital Status Single Married Divorced Widowed
Status Perkahwinan Bujang Berkahwin Bercerai/Janda Duda/Janda
If yes, state
Personal Transportation
the class
Driving license Yes No (Car / Bike / Others)
Jika ya,
Lesen Memandu Ya Tidak Kenderaan peribadi
nyatakan
(kereta / motor / lain-lain)
kelas

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 FAMILY DETAILS
MAKLUMAT KELUARGA
Relationship Name Age Occupation Employer / School / College / University
Hubungan Nama Umur Pekerjaan Majikan / Sekolah / Kolej / Universiti
Father
Bapa

Mother
Ibu

Siblings
Adik beradik

SPOUSE DETAILS
MAKLUMAT SUAMI / ISTERI
Spouse name
Nama suami / isteri

Correspondence address
Alamat surat menyurat

MyKAD no. Birth date Race

No. MyKAD Tarikh lahir Bangsa
Occupation Employer
Pekerjaan Majikan
Mobile no.
Office telephone no.
No. telefon
No. telefon pejabat
bimbit

CHILDREN DETAILS
MAKLUMAT ANAK
Relationship MyKAD / Birth
Birth date
Hubungan Name Tarikh
Gender Age Cert No. Employer / University / College / School
Nama Jantina Umur MyKAD/Birth Cert Majikan / Universiti / Kolej / Sekolah
lahir
No

Children
Anak

Handicapped
children
(if any)
Anak kurang
upaya
(jika ada)

PERSON TO CONTACT IN CASE OF EMERGENCY

INDIVIDU YANG HARUS DIHUBUNGI SEKIRANYA BERLAKU KECEMASAN
Name Relationship Mobile no.
Nama Hubungan No. telefon bimbit

Correspondence Address
Alamat surat menyurat

Correspondence Address
Alamat surat menyurat

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 EDUCATION INFORMATION
MAKLUMAT PELAJARAN (PENDIDIKAN)

Year
Tahun
No.
From To University / College / School Course CGPA / Grade*
(dd/mm/yy) (dd/mm/yy) Universiti / Kolej / Sekolah Kursus
Dari (t/b/t) Hingga CGPA / Gred *
(t/b/t)
1

* Copies of relevant certificates must be attached

* Sila sertakan salinan sijil-sijil

Scholarship (if any)
Biasiswa (jika ada)
Employment Bond Penalty in default
Type held (no. of years) Name of Sponsor (RM)
No.
Jenis Kontrak Pekerjaan Nama penaja Denda melanggar kontrak
(bil. tahun) (RM)
1

PROFESSIONAL TRAINING & COURSES (IF ANY)

LATIHAN & KURSUS PROFESSIONAL (JIKA ADA)

Training / Course Institution Qualification Year

No
Latihan / Kursus Latihan / Kursus Kelayakan Tahun
1

EXTRA CURRICULAR ACTIVITIES

KEGIATAN KO-KURIKULUM (TAMBAHAN)

At School
1 Di Sekolah

At University
2 Di Universiti

Currently
3 Pada masa ini

LANGUAGE (PLEASE TICK “√” IN APPROPRIATE BOXES)

BAHASA (SILA TANDA “√” DI TEMPAT YANG SESUAI)
Spoken Written
Pertuturan Penulisan
Very
Excellent
Very Good Good Fair Poor Excellent Good Good Fair Poor
Language (5)
(4) (3) (2) (1) (5) (4) (3) (2) (1)
Cemerlang
Sangat Baik Baik Sederhana Lemah Cemerlang Sangat Baik Sederhana Lemah
(5)
(4) (3) (2) (1) (5) Baik (3) (2) (1)
(4)
1 Bahasa Malaysia

2 English

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 EMPLOYMENT HISTORY (START WITH PRESENT OR LAST EMPLOYER)
PEKERJAAN TERDAHULU (BERMULA DENGAN MAJIKAN SEKARANG ATAU TERAKHIR)
From To
Company (dd/mm/yy) (dd/mm/yy) Basic pay Fixed income / allowance
Syarikat Dari Hingga Gaji Asas Elaun tetap
(Tarikh/Bulan/Tahun) (Tarikh/Bulan/Tahun)
Position
Jawatan
Tel no. Brief description of duties
No telefon Ringkasan Tugas

Address
Alamat

Reason for leaving or desiring to leave

Sebab berhenti atau ingin berrhenti

From To
Company (dd/mm/yy) (dd/mm/yy) Basic pay Fixed income / allowance
Syarikat Dari Hingga Gaji Asas Elaun tetap
(Tarikh/Bulan/Tahun) (Tarikh/Bulan/Tahun)
Position
Jawatan
Tel no. Brief description of duties
No. telefon Ringkasan Tugas

Address
Alamat

Reason for leaving

Sebab berhenti
From To
Company (dd/mm/yy) (dd/mm/yy) Basic pay Fixed income / allowance
Syarikat Dari Hingga Gaji Asas Elaun tetap
(Tarikh/Bulan/Tahun) (Tarikh/Bulan/Tahun)

Position
Jawatan

Tel no. Brief description of duties

No. Tel Ringkasan Tugas

Address
Alamat

Reason for leaving

Sebab berhenti

Page 4 of 7
 From To
Company (dd/mm/yy) (dd/mm/yy) Basic pay Fixed income / allowance
Syarikat Dari Hingga Gaji Asas Elaun tetap
(Tarikh/Bulan/Tahun) (Tarikh/Bulan/Tahun)
Position
Jawatan

Tel no. Brief description of duties

No. telefon Ringkasan tugas

Address
Alamat

Reason for leaving

Sebab berhenti

OTHER INFORMATION
MAKLUMAT LAIN
Have you ever been convicted in court, apart from traffic If yes, state nature
offences? Yes No Jika ya, sila nyatakan
Pernahkah anda didakwa di mahkamah, selain kesalahan Ya Tidak
trafik
If yes, state nature
Have you ever taken any prohibited drugs? Yes No Jika ya, sila nyatakan
Pernahkah anda mengambil sebarang jenis dadah terlarang? Ya Tidak

Are you on any prescribed medication or are you currently If yes, state nature
receiving any medical treatment? Yes No Jika ya,sila nyatakan
Adakah anda mengambil/ sedang mengambil ubat-ubatan Ya Tidak
secara berterusan?

Have you ever been declared a bankrupt in any country? Yes No

Pernahkah anda diisytihar muflis/bankrap Ya Tidak

Are you pregnant? (applicable for female applicants only) Yes No

Adakah anda hamil? (untuk pemohon wanita sahaja) Ya Tidak

If pregnant, please state the due date

Jika hamil, sila nyatakan tarkh jangkaan kelahiran

LIST TWO REFEREES WHO KNOW YOU PERSONALLY (EXCLUDING FAMILY MEMBERS)
SENARAIKAN DUA RUJUKAN PENAMA YANG MENGENALI DIRI ANDA (BUKAN AHLI KELUARGA)
Name Occupation Employer & Address Relationship HP No.
Nama Jawatan Majikan & Alamat Hubungan No. telefon bimbit

Previous Superior
1 Pengurus Terdahulu

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 CAREER EXPECTATION
PERANCANGAN KERJAYA

How can you contribute to the success of CCM?

Bagaimanakah anda dapat menyumbang ke arah kejayaan CCM?

OTHERS & DECLARATION

LAIN-LAIN & PENGAKUAN
If offered employment, please state the earliest date you can start work / notice required
Sekiranya ditawarkan oekerjaan, nyatakan tarikh anda mula bekerja / notis diperlukan
Expected salary
Gaji dipohon
Do you know anyone working in CCM? If yes, please provide the name & relationship
Adakah anda mengenali sesiapa yag bekerja di CCM? Jika ya, sila nyatakan nama &
perhubungan
Have you attended any interview in CCM? If yes, for what position and when
Pernahkah anda menghadiri temuduga di CCM sebelum ini? Jika ya, nyatakan jawatan dan
tarkh
I certify that the information given in this application form is to my knowledge true and correct and that I have not willfully misstated any
facts. I understand that if I am employed, I shall be liable to immediate dismissal if at any time hereafter it becomes known that I have
made false, evasive or given misleading statements in this application.
Saya akui bahawa segala maklumat yang diberikan di dalam borang permohonan ini adalah benar dan tiada pemalsuan. Saya juga bersetuju agar perkhidmatan saya
ditamatkan dengan segera sekiranya terdapat sebarang maklumat yang tidak benar ataupun palsu.

Should my application for employment be accepted, I hereby declare that I shall at all times observe the company’s rules and
regulations and obey all instructions given by the company.
Sekiranya saya ditawarkan pekerjaan, saya bersetuju akan sentiasa mematuhi segala syarat dan peraturan serta segala arahan yang ditetapan oleh pihak majikan

Signature Date
Tandatangan Tarikh

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FOR COMPANY/OFFICIAL USE:
UNTUK KEGUNAAN PEJABAT SAHAJA

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