FMC GREENLAND SDN BHD

18, Jalan BP 5/11, Bandar Bukit Puchong, 47100 Puchong, Selangor Darul Ehsan.
Tel: 03-8060 8257/8258 Fax: 03-8060 8259/4739
Webpage: www.bmsorganics.com

APPLICATION FOR EMPLOYMENT

Note: 1. Please read through this form carefullt and fill in block letters.
2. It should be returned with one passport size photo (non-returnable)
3. Please enquire wherever there is any doubt.

POSITION APPLIED FOR:

PERSONAL DETAILS:
Name (Mr / Mrs / Miss) Chinese Character (if applicable)
_______________________________________________ _______________________________________________

Corresponding Address : Telephone No. : _______________________________

_______________________________________________ Handphone No. : _______________________________
_______________________________________________
Email : _______________________________
_______________________________________________

Permanent Address : Telephone No. : _______________________________

_______________________________________________ Handphone No. : _______________________________
_______________________________________________
Email : _______________________________
_______________________________________________

Date Of Birth : ______________________________ NRIC No. : _______________________________

Place Of Birth : ______________________________ AGE : _______________________________
Gender (circle) : Female / Male Race / Religion : _______________________________
Marital Status (circle) : Single / Married (Pregnant : Yes / No) / Others

STATUTORY ACCOUNTS NO

KWSP No. : ______________________________ Income Tax No. : _______________________________

PERKESO No. : ______________________________ I/Tax Branch : _______________________________

FAMILY PARTICULARS

Spouse’ Name : ______________________________ Date of Marriage : _______________________________

NRIC No. : ______________________________ Date of Birth : _______________________________
Occupation : ______________________________ Telephone No. : _______________________________
Spouse’ Employer : ______________________________ Mobile No. : _______________________________

Name of Children / Siblings / Parents Age Occupation / School Employer

1)
2)
3)
4)
5)
Father’s Name : __________________________________________ Occupation : _______________________________
Mother’s Name : __________________________________________ Occupation : _______________________________

PERSON TO BE NOTIFIED IN CASE OF EMERGENCY

Name : __________________________________________ Relationship : _______________________________

Address : __________________________________________ Phone No (Resident) : _______________________________
__________________________________________ Phone No (Office) : _______________________________
 __________________________________________ Mobile No : _______________________________

HR/REC/APPLIC/01/120314/CMC

EDUCATION, TRAINING & SKILLS

Education

; : : : . Name Of University / Qualification Tertiary Qualifications (if any) Year Of Graduation College / Institution Acquired Ist
Degree 2nd Degree (if any) Diploma

Professional / Technical / Commercial Certificate

SPM

Other

Notes:

1. Photocopies of above result / certificates are to be attached to this form

2. Original copies of certificates testimonials etc. must be produced at the time of interview

and Dialects

Language And Indicate Whether

Dialects Read

Chinese

Others : -

Technical Skills

/ Technical / Other

34

EMPLOYMENT RECORDS ( Please list from the latest )

/ Fair /Fluent For Clerk / T

Write Ww.

Shorthand

Indicate level: / Intermediate /

Position : Employer

Immediate Superior

Reason for Leaving

Brief Description of your duties and responsibilities:

From : To: Last Drawn Basic Salary

Last Drawn Allowance

Last Drawn Incentive

No. of Subordinates

Position : Employer : Immediate Superior : Reason for Leaving 7

Brief Description of your duties and responsibilities:

From: To: Last Drawn Basic Salary

Last Drawn Allowance

Last Drawn Incentive

No. of Subordinates

Position
 Employer Immediate Superior Reason for Leaving

Brief Description of your duties and responsibilities:

From : To: Last Drawn Basic Salary

Last Drawn Allowance

Last Drawn Incentive

No. of Subordinates

HR/REC/APPLIC/01/120314/CMC

OTHER INFORMATION

1) Do you have your own transport? oO If yes, please indicate type

2) Do you have a valid driving license? oO If yes, please indicate class of license

3) Have you ever been under police investigation, charged or convicted in court Oo of law in any country?

4) Are you an undischarged bankrupt? Oo

5) Have you taken any loan? o If yes, kindly indicate nature of loan and institution where it is obtained

6) Do you smoke?
7) Are you involved in any direct sales / network marketing? If yes, kindly indicate which company

og

8) Have you been hospitalised before? oOo If yes, kindly indicate reason for hospitalisation

9) Do you have any physical disability, handicap, serious illness, accidental Oo injury or medical condition? If yes, kindly indicate

10) Are you currently undergoing any long-term medical treatment? oO If yes, kindly indictae type and purpose of treatment

11) Do you have any friends, family members or relatives presently or formerly Oo in our employment? If yes, kindly indicate who
they are

12) Have you applied with us before? Oo If yes, when and for what position?

13) How you get to know this position? (Through online advertisement, Newspaper, Introduce by someone?) please write down
introducer name and contact number

14) Kindly give any other information in support of this application.

15) What is your expected basic salary?

16) If selected, how soon can you commence?

oa

og

Give more information which will help us to consider your application and know you more:-

Strengths Weakness (i) (i)

HR/REC/APPLIC/01/120314/CMC

ee

-REFERENCE CHECK-AND VETTING ne =

1) Kindly provide few professional including you most recent employer/ or academic referees.

Name and Title Contact Years known | Relationship Company / Institution

DECLARATION

I hereby declare that the particulars given by me in this application form are true to the best of my knowledge and belief to be
correct and true. I understand that any false statement or witholding of any relevant information may provide grounds for any
withdrawal of any offer of appointment or for its immediate cancellation if the appointment has been accepted and instant
dismissal if employed.

Signature of applicant: Date

FOR OFFICE USE ONLY

O Outlet: O HQ

Ist Interview by Comment: Proceed to hire / KIV / Reject / Date : Arrange 2nd interview Interviewer's Overall Comments:

2nd Interview by Comment: Proceed to hire / KIV / Reject / Date

Interviewer's Overall Comments:

If hire, Signed & Approved By : Commencing Salary Date : Allowance Others Comm & Profit Sharing Commencing Position
Commencing Date ; Staff Grade (if any ) Commencing Date Outlet

REMARKS

Commission and profit sharing start date for Retail Staff ( Outlet ):

***If staff joined before or on the 7th of the month, the new staff will be entitled to commission from the second appointed
month

***If staff joined after the 7th of the month, the new staff will only be entitled to commission from the third appointed month

HR/REC/APPLIC/01/120314/CMC