Instructions :

1. Please complete this form with your own handwriting

2. Please attach latest payslip, duplicated copy of IC and all relevant educational
certificates and testimonials to this form. Originals are to be produced at the
interview. Attach
Photograph

EMPLOYMENT APPLICATION FORM

PERSONAL INFORMATION
PENERANGAN PERIBADI

Position applied for

Jawatan yang dipohon
Full Name(as per I.C.)
Nama Penuh
Address Handphone
Alamat Telefon Bimbit
House Tel
Rumah
NRIC No
Nombor IC
Marital Status Single Married Divorced Sex Male Female
Taraf perkahwinan Bujang Kahwin Cerai Jantina Lelaki Perempuan
Date of Birth Age Nationality Race Religion
Tarikh Lahir Umur Warganegara Keturunan/Bangsa Agama
Driving Licence Class
Yes No
Lesen memandu Kelas
Type of vehicles owned Email address
Jenis kenderaan yg dimiliki Alamat email

LANGUAGES & DIALECTS PROFICIENCY

KEFASIHAN BAHASA & LOGHAT
Language Spoken Good Fair Bad Language Writen Good Fair Bad
Bahasa Pertuturan Baik Sederhana Kurang Baik Bahasa Penulisan Baik Sederhana Kurang Baik

ACADEMIC BACKGROUND
AKEDEMIK

List below your attendance at all Universities/Colleges/Schools. Kindly attach copies of Degree/Diploma /Certificates
Senaraikan kelulusan disemua universiti, kolej dan sekolah. Kepilkan sijil-sijil kelulusan.

Primary / Secondary School/ College/ Universiti Year

Attended Certificate/ Examination Result / Award
Sekolah Rendah / Menengah/ Kolej/ Universiti yang dihadiri From To Obtained

Other Courses / Training Attended Year Result / Award Obtained

Duration
Kursus-kursus / Latihan lain yang dihadiri Tahun Sijil Diterima
 EMPLOYEMENT HISTORY
PENGALAMAN BEKERJA

PRESENT EMPLOYER
Period of employment (State mth & yr) From to
Berapa Lama bekerja Dari hingga
Name Of Employer
Nama Majikan
Nature Of Business Location
Jenis Perniagaan Lokasi
Position Held Dept
Jawatan Dipegang Bahagian
Duties ( details of work performed )
Kerja yang dikendalikan

Reason for Leaving Last Drawn Salary

Sebab berhenti Gaji akhir

PREVIOUS EMPLOYERS
Period of employment (State mth & yr) From to
1 Berapa Lama bekerja Dari hingga
Name Of Employer
Nama Majikan
Nature Of Business Location
Jenis Perniagaan Lokasi
Position Held Dept
Jawatan Dipegang Bahagian
Duties ( details of work performed )
Kerja yang dikendalikan

Reason for Leaving Last Drawn Salary

Sebab berhenti Gaji akhir

Period of Employement ( state mth & yr ) From to

2 Berapa lama bekerja Dari hingga
Name Of Employer
Nama Majikan
Nature Of Business Location
Jenis Perniagaan Lokasi
Position Held Dept
Jawatan Dipegang Bahagian
Duties ( details of work performed )
Kerja yang dikendalikan

Reason for Leaving Last Drawn Salary

Sebab berhenti Gaji akhir

Period of Employement ( state mth & yr ) From to

3 Berapa lama bekerja Dari hingga
Name Of Employer
Nama Majikan
Nature Of Business Location
Jenis Perniagaan Lokasi
Position Held Dept
Jawatan Dipegang Bahagian
Duties ( details of work performed )
Kerja yang dikendalikan
Reason for Leaving Last Drawn Salary
Sebab berhenti Gaji akhir

FAMILY PARTICULARS
KETERANGAN KELUARGA
Spouse’s Name Occupation
Nama suami/Isteri Pekerjaan
Employer’s Name Nature of Business
Nama Majikan Jenis Perniagaan

Children’s Name/ Age If Employed, Nature of employment & Employer’s Name

Nama/ Umur anak Jika bekerja ,jenis perkerjaan dan nama majikan

Father’s Name/ Occupation Mother’s Name/ Occupation

Nama/ Pekerjaan Bapa Nama/ Pekerjaan Ibu

Employer’s Name Employer’s Name

Nama majikan Nama majikan

Nature Of Business Nature of Business

Jenis perniagaan Jenis perniagaan

CHARACTER REFEREES
PENGADILAN KELAKUAN

Please name two referees; one should be a business referee who is acquainted with your current or past work
employment i.e present or past immediate Superior.
Sila namakan dua orang kenalan di mana seorang merupakan kenalan di tempat kerja semasa atau kenalan di tempat kerja yang lalu contohnya
Penyelia semasa atau Penyelia yang dahulu..

Full Name Full Name

Nama penuh Nama penuh

Name of Company Name of Company

Nama syarikat Nama Syarikat

Office tel House tel Office tel House tel

Pejabat Rumah Pejabat Rumah

Designation Years known Designation Years known

Jawatan Jangkamasa berkenalan Jawatan Jangkamasa berkenalan

OTHERS
LAIN-LAIN

1. May we contact your previous Employer (s ) ?

If yes, please state the Name / Tel No of contact person :
Bolehkah kami menghubungi majikan anda yang lama . Jika ya, sila berikan no tel dan nama pengurus.

2. May we contact your present Employer ?

If yes, please state the Name / Tel No of contact person :
Bolehkah kami meghubungi majikan anda. Jika ya, sila berikan nama pengurus .

3. Do you have any friends / relatives working in this Company ?

If yes , please state the Name / Designation :
Adakah kamu mempunyai kawan / saudara bekerja di dalam syarikat ini ? Jika ya, sila berikan nama dan jawatan beliau .
4. Any history of illness / operations of physical impairment ?
If yes , please provide brief details :
Pernahkah kamu mengalami apa-apa penyakit ataupun kecederaan yang serius ? Jika ya , sila berikan keterangan lanjut.

5. Is there any relationship (financial or otherwise) that could result in a conflict of interest between you and the
Company ?If yes, please provide details
Adakah kamu mempunyai apa-apa kepentingan yang bercanggah dengan syarikat ? Jika ya, sila beri keterangan.

6. Have you ever been convicted of a criminal offence or sued for civil proceeding ?
If yes , please provide details
Pernahkah kamu didakwa di mana-mana mahkamah jenayah atau prosiding awam. Jika ya, sila berikan keterangan .

7. Have you ever been suspended or dismissed from employment ?

If yes , please provide details
Pernahkah kamu digantung kerja atau diberhentikan kerja? Jika ya, sila berikan keterangan

8. Have you ever been adjudged a bankrupt ?

If yes , please provide details
Pernahkah kamu diadjudikasi sebagai seorang bankrupt?

9. For females, please state whether you are currently pregnant? If yes, please specify
Bagi wanita, sila nyatakan sama ada anda sedang mengandung. Jika ya, sila nyatakan.

10. Personal Interests :

Kegemaran

11. Add here anything which you consider important and helpful to us in assessing your suitability position you
have applied for
Sila tulis di sini apa-apa yang anda fikir boleh menolong kami untuk menilai permohonan ini.

12. Expected Remuneration?

Jangkaan gaji

13. When are you able to commence work?

Bilakah kamu boleh mula bekerja

THIS APPLICATION IS NOT COMPLETE UNTIL THE FOLLOWING HAS BEEN READ AND SIGNED :

I certify that all of the information furnished on this form is true, complete and correct to the best of my
knowledge.
I understand that any false statements made by me on this form or any supplement thereto or in connection
with the above mentioned application may result in immediate termination of my employment with this
Company .

Pemohonan ini tidak lengkap sehingga keterangan berikut telah dibaca dan ditandatangan : Saya mengesahkan bahawa keterangan
yang saya beri ini adalah benar dan betul pada pengetahuan saya. Saya faham bahawa apa-apa keterangan palsu yang saya buat di
dalam borang ini boleh mengakibatkan pemberhentian kerja dengan serta merta .

___________________________ ____________________
Signature Date

FOR OFFICE USE

UNTUK KEGUNAAN PEJABAT

Interviewer’s comments_______________________________________________________________________

The interviewer’s recommendation:

Employ as ______________________ Commencing Date _________________ Location_________________

Basic Salary _____________________Allowances (specify) _______________ Others __________________

Interviewer’s Name _____________________________ Department _______________________________

Interviewer’s Signature ____________________________ Approval _________________________________