Please affix your recent

passport photo here.

EMPLOYMENT APPLICATION FORM
UNIVERSITI TUN ABDUL RAZAK SDN. BHD.
LOT 195-A, JALAN TUN RAZAK
50400 KUALA LUMPUR

NOTES:
1. This form is to be completed before the interview session.
2. All questions must be answered accurately and furnishing full details. However, please indicate "NA" where it is not
applicable.
3. Please attach a copy of your NRIC or passport showing all relevant details.
4. Please attach photocopies/scanned of all your academic education certificates, 3-month payslip & any relevant supporting
documents. You are to present the original documents during the interview.
5. Any false statements or withholding of any relevant information may provide grounds for the withdrawal of an offer of
appointment or dismissal.

POSITION APPLIED FOR:

Possible Date of Commencement: Current Salary: RM

Notice Period: Expected Salary: RM

A. PERSONAL INFORMATION

Full Name:

Current Address:

Permanent Address:

- -
New NRIC:

Contact No. (Phone): Gender:

(Home): Race:
Email: Religion:
Date of Birth: Marital Status:
Place of Birth: Age:
EPF No.: SOCSO No.:
Passport No.: Citizenship:

SPOUSE INFORMATION

Name: Contact No.:

Employer: Occupation:

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B. DETAILS OF FAMILY MEMBERS (Spouse / Children / Parents / Siblings)

No. Full Name Relationship Age Employer/Occupation

EMERGENCY CONTACT DETAILS

Name: Contact No.:

Relationship: Occupation:

C. EDUCATION QUALIFICATIONS

University / College / School Year

Awarded Degree/ Diploma/ Certificate(s)
(from highest to lowest) From To

D. PROFESSIONAL MEMBERSHIP/ COURSE

Name of Association Member Since Type of Membership / Level

(mm/yyyy)

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E. EMPLOYMENT HISTORY

Name of Company:
Type of Industry: From (mm/yyyy):
Location: To (mm/yyyy):
Starting Salary Last Drawn Salary Job Title / Position
Starting:
RM RM
Last Held:

Brief description of responsibilities:

Name of Company:
Type of Industry: From (mm/yyyy):
Location: To (mm/yyyy):
Starting Salary Last Drawn Salary Job Title / Position
Starting:
RM RM
Last Held:

Brief description of responsibilities:

Name of Company:
Type of Industry: From (mm/yyyy):
Location: To (mm/yyyy):
Starting Salary Last Drawn Salary Job Title / Position
Starting:
RM RM
Last Held:

Brief description of responsibilities:

Name of Company:
Type of Industry: From (mm/yyyy):
Location: To (mm/yyyy):
Starting Salary Last Drawn Salary Job Title / Position
Starting:
RM RM
Last Held:

Brief description of responsibilities:

*Please write on separate paper if space is insufficient

If NO, please state

Name and Position Contact No.
reason:
May we contact your
current employer? Yes,
May we contact your
previous employer(s)? Yes,

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Rev. 5: 20/09/2022
F. LANGUAGE PROFICIENCY (Please indicate B = Basic I = Intermediate F = Fluent)

Language / Dialect Speak Read Write

Bahasa Malaysia
English
Others:

G. COMPUTER / OTHER SKILLS (computer software, typing, shorthand, etc.)

Level of Proficiency (please tick √)

Type of Skills
Beginner Intermediate Advanced

H. CHARACTER REFERENCES (List two personal referees who are not your relatives)

Name Occupation Address and Contact No. Period Known

I. LEISURE INTERESTS

Hobbies:
Societies / Clubs:

J. GENERAL INFORMATION (please tick √)

No Yes If yes, please specify:

1. Have you ever been charged or convicted in
any Court of Law?

2. Have you ever been declared Bankruptcy or

charged under Bankruptcy Act?

3. Have you ever been involved in any

Labour/Industrial Relations cases?

4. Have you been, or are you suffering from any

physical impairment or illness/ disease?

5. Are you on any prescribed medication or are

you currently receiving any medical treatment?

6. Are you bound to serve any organisation or

public institution?

7. Have you completed COVID-19 vaccination?

(Dose 1, 2, Booster)

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Rev. 5: 20/09/2022
 No Yes
8. Do you have any friends or relatives that are currently or were employed by UNIRAZAK
or any of its subsidiaries?
*If yes, please provide the following information:

Name Department Designation Relationship

9. Please fill in other information which you think is relevant for our consideration.

K. CONSENT FOR DATA PROCESSING

In pursuant to Section 6(1) of the Personal Data Protection Act 2010, I hereby give my consent to Univesiti Tun
Abdul Razak Sdn. Bhd. (hereinafter referred to as "the Data User") held by the Data User for employment purpose.

Signature: Date:

L. DECLARATION

I declare that the information given in this application is complete and accurate to the best of my knowledge.
Enclosed are copies of supporting documents as listed above. I fully understand and accept that if at any time after
my employment, it is found that any false declaration has been made in this form, including withholding of any
relevant information, the Company has the absolute right to summarily terminate my employment forthwith.
I signify my understanding and agreement to the foregoing by signing below.

Signature: Date:

FM-HR-01
Rev. 5: 20/09/2022