STATEMENT & DECLARATION

I. Do you have any pending employment applications with other firms or companies? Y/ N
II. Do you have any relatives/ friends working in our firm? Y/ N
III. Do you own any shares in, or are you a director of any firms or companies? Y/ N
IV. Have you ever been convicted of any offences? Y/ N
V. Have you ever suffered from mental breakdown/ serious injuries/ physical defects? Y/ N
VI. Have you ever been declared bankrupt or filed for bankruptcy before? Y/ N
VII. Do you have any outstanding unsecured debts amounting to more than SGD 2000? Y/ N
VIII. Do you suffer from any major illness or medical condition that may require you to be away from work regularly? Y/ N
IX. You may be required to undergo further health medical check- up at our panel clinic during your probation or upon Y/ N
confirmation of employment at the discretion of the Management due to work requirements.
X. Have you ever been dismissed or terminated by any of your former employer(s)? Y/ N
XI. Have you ever received any written warnings from your previous employments due to your work performance, Y/ N
tardiness, insubordination, misconducts or etc.
XII. You may be required to install and use certain app on your smart phone device from time to time for work related purposes Y/ N
XIII. Did you include all your previous employment in your updated resume? If NO, what are the reasons for exclusion? Y/ N
XIV. Are you currently expecting or do you have any plans for pregnancy in the next 12 months? Y/ N

If you have answered “yes” to any of the questions above, please provide the details below:
J O B A P P L I C A T IO N F O R M

By ticking this box, I have read and agree with your Personal Data Privacy Notice ("PDPN" ) (http://joeyyap.com/misc/policy.asp).
NAME
I hereby declare that all the particulars furnished in this application to the best of my knowledge and belief, are true and correct and I have
not knowingly omitted any related information of an adverse nature. I understand that if any of the particulars provided herewith are proven
to be untrue, misleading or misrepresentative, I am liable for immediate dismissal. I further authorize the “firm” to verify the information
given herein.
POSITIONAPPLIED

INTERVIEWDATE&TIME
Interviewed by: Venue:

Date: : Time:

Candidate was: Early Punctual Late

CV’s and / or Resume furnished: Yes No

Pay slips, photograph & related documents furnished (inc certificates): Yes No

JOEY YAP GROUP OF COMPANIES

Checklist & Quick Rating Reference:

Punctuality: Early Punctual Late

Completeness of CV, documents & certificates: Very complete Moderate Insufficient

Citation & verification of certificates: Yes No

Citation & verification of pay slips: Yes No Not applicable (Fresh graduate)
 This application is to be completed by individuals applying for full time positions Questions followed by a checkbox may be answered by marking either a or a 1. EDUCATION BACKGROUND
PERSONAL PERTICULARS
only. Part timers will be required to fill in a different form. Depending on the position next to the appropriate answer. Some questions provide a blank space for you to
applied, you may be given supplementary forms which requires the candidate to
Please list all education beginning with high school and indicate any diplomas or degrees completed:
enter your information. Please answer those items as well. If the item does not apply,
complete and return as part of the job application process. enter “N/A” for ‘not applicable’. This lets us know you saw and answered it. Please Level: Instituition Name & Location: Course: Grades:
complete the form as accurately and completely as possible.
High School

CHECKLIST College
University
I have enclosed the following: I applied for this Job via:
Attach a Others
recent passport size
Curiculum Vitae Advertisement
photograph
Photograph Agency
2. EMPLOYMENT RECORD
3 Months Pay Slip Friends Please list your employment record starting with the three most recent position.
Company Name: Years: e.g. 1991 - 1995 Duration: e.g. 5mth / 5yrs Designation:
Certificates / Transcripts Others

PERSONAL PARTICULARS
Current Address:

Email: 3. PROFESSIONAL MEMBERSHIPS

Extra-curricular / community activities. e.g. List of membership of clubs, societies and associations.
Mobile: Gender:

Membership: A. B.
Date of Birth: Age: Position Held:

Time of Birth: Place of Birth: Achievements:

Nationality: Religion:
4. REFEREES
Please furnish non-family related referees who you’ve had the pleasure of working with in the past. He/she must currently be residing in Malaysia.
Marital Status: Single Married Divorced Children: Son(s) Daughter(s)
Name: A. B.
Do You Drive Yes No Are you currently still Company Name:
to Work: under employment? Yes No
Contact Number:
Company Name
Designation:
(Current): Relationship:
Designation:
Expected Salary
Current Salary (RM):
monthly (RM): Years of Acquaintance:
Earliest Resignation
commencement date: notice period:

FAMILY BACKGROUND
Relationship:
Spouse (if married)
5. TELL US MORE ABOUT YOU (in less than 100 words for each question.)
Name: Occupation & Company: Contact Number:
I. What are your 3 most important attributes or key strengths?

Father

Mother
Siblings:
(please state relationship) Name: Occupation & Company: Contact Number: II. What do you value most in your career and and why is it so important to you?