Pontian United Plantations Berhad

(Company No. 2121-P)

APPLICATION FOR EMPLOYMENT

Position Applied: (1) _______________________________

(2) _______________________________
1. Personal Particular
Name

Home Address

Postal Address

(if different)
Date of Birth

: ___________________ Place of Birth

: _______________

Nationality

: ___________________ Race

: _______________

Religion

: ___________________ Sex

: _______________

NRIC No. (New)

: ___________________ NRIC No. (Old) : _______________

Passport No

: ___________________ Marital Status

: _______________

EPF No.

: ___________________ Socso No.

: _________________

Income Tax

: ___________________

Tel. No. (House) : ___________________ Tel. No. (H/P)

: _______________

Married applicant, please state the following:

Name of Spouse

: _______________________________________________

Occupation

: ______________________ Nationality: _______________

Name of Employer

: _______________________________________________

Childrens Particulars
Name

Date of
Birth

Sex

School / Institution

Family Background
Name

Relationship

Age

Occupation

Father
Mother

2. Educational Background
Year
From

School / Institution
To

Qualification
Obtained

Grade /
Score

Please state language ability

Spoken

Level / Rating

Written

Level / Rating

Have you suffered from any medical sickness that causes mental and physical
limitation?
Yes
No
If yes, please state ____________________________________________________

Have you ever been convicted of any crime in the part?

Yes

No

3. Present / Previous Employment

Year
From

Company

Designation

Last Drawn Remuneration

Reason for Leaving

To
Basic Salary : RM ___________________________
Allowances:
1. _________________________ RM _____
2. _________________________ RM _____
3. _________________________ RM _____
Basic Salary : RM ___________________________
Allowances:
1. _________________________ RM _____
2. _________________________ RM _____
3. _________________________ RM _____
Basic Salary : RM ___________________________
Allowances:
1. _________________________ RM _____
2. _________________________ RM _____
3. _________________________ RM _____
Basic Salary : RM ___________________________
Allowances:
1. _________________________ RM _____
2. _________________________ RM _____
3. _________________________ RM _____
Basic Salary : RM ___________________________
Allowances:
1. _________________________ RM _____
2. _________________________ RM _____
3. _________________________ RM _____
Basic Salary : RM ___________________________
Allowances:
1. _________________________ RM _____
2. _________________________ RM _____
3. _________________________ RM _____
Basic Salary : RM ___________________________
Allowances:
1. _________________________ RM _____
2. _________________________ RM _____
3. _________________________ RM _____

Please state what is your expected salary

Notice Required to current Employer

RM

(Excluding / Including Allowances)

Please provide 2 references of which one must be your present or past employer.

Reference 1
Name
Position
Company Address

Tel No.

Reference 2
Name
Position
Company Address

Tel No.
I certify that the information stated in this form is correct to the best of my knowledge.
I also authorized any rightful representative from Pontian United Plantations Berhad
to make such investigations and inquiries of my personal, employment, financial or
medical history and other related matters as may be necessary in arriving at an
employment decision. I hereby release employers, schools or persons from all
liability in responding to inquiries in connection with my application.
In the event of employment, I understand that false or misleading information given
in my application or interview(s) may result in my instant dismissal. I understand
also, that I am required to abide by all rules and regulations of the Company, should
I be hired.

Signature of applicant: _________________________ Date: __________________

Kindly mail this form to:
Pontian United Plantations Berhad
Human Resource Department
P.O. Box 60525, 91114 Lahad Datu, Sabah, Malaysia