Employment Application

Source Private & Confidential

Newspaper Recommendation Job fair Online
Walk-in Recruitment agency Other please specify

I hereby declare that all the particulars given below are, to the best of my knowledge and belief, true.
I understand that should any particulars be found to be untrue in the course of my employment, I may
be liable to immediate dismissal. PHOTO
Applicant’s signature Date ddmmyy
X
Position applied for Expected salary p/month

Personal particulars Please complete in BLOCK letters

Full name As appears in IC; underline surname

Alias if any NRIC New NRIC Old

- -
Date of birth ddmmyy Place of birth Nationality

Sex Race Religion Marital status

Mailing / current address
Telephone Home
0 -
Postcode Telephone Mobile
0 -
Permanent address
Telephone
0 -
Postcode Telephone
0 -
Physical disabilities if any

Spouse’s name Telephone

0 -
Occupation At Company name

Children Name Sex Date of birth ddmmyy

Your father’s name Occupation

Your mother’s name Occupation

Brothers & sisters Name Sex Age Occupation

Next of kin Name Relationship

Address
RS/PDFEMP/E/122008

Telephone Home
-
Postcode Telephone Mobile
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Education
School Name From Year To Year Details of examination results

College or university Name From Year To Year Details of examination results

Name of scholarships held if any

Post graduate research if any

Employment bond or financial debts if any

Professional qualifications if any

Skills, computer literacy & languages

Please tick the appropriate box if you have any of the following skills
Skills Fair Good Excellent
Drawing Computer skills Specify software
Sculpting Word processing
Other Spreadsheet
Database management
Typing wpm Graphics
Shorthand wpm
Languages spoken Fair Good Excellent Languages written Fair Good Excellent
Bahasa Malaysia Bahasa Malaysia
English English
Mandarin Mandarin
Other Other

Extramural activities
Position in your clubs / societies if any

Games played, and your level of representation

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Description of career IMPORTANT This section is to be filled by applicants who are presently or previously employed.
Apart from the specialized qualifications and experience you have outlined, please give a brief description, in your own words, of
your professional and business career since leaving school/college/university.

Present or last employment

Company Name Type of business

Address

Postcode Telephone
-
Date joined ddmmyy Starting salary Date left ddmmyy Present / last salary

Position held Termination notice period

Brief description of duties

Reason(s) for leaving

Other employment experience

Company Name Period Position held Last salary Reason(s) for leaving

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References Please complete in BLOCK letters
Please provide three references (Original testimonials should not be forwarded). References can be drawn from the following:
i Someone in a position of responsibility in the private sector or in public life
ii The principal or lecturerer at your last school / college / university
iii Your present employer (References will not be taken up without the candidate’s authorization)
1 Name Position Relationship

Address

Postcode Telephone
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2 Name Position Relationship

Address

Postcode Telephone
-
3 Name Position Relationship

Address

Postcode Telephone
-
Miscellaneous
Have you ever been convicted of a criminal offence? If yes, please specify

Are you presently undergoing any medical treatment? If yes, please specify

OFFICE USE ONLY

Accept Date joined ddmmyy Position offered
Reject
KIV Starting salary Department Section Grade Level
Other

Interviewer(s) Remarks Signature Date

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