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PERSONAL PARTICULARS
Full Name (with qualifications in brief):
Date of Birth:
Place of Birth:
Nationality:
Citizenship:
Marital Status:
Religion:
Sex:
Country of
Domicile:
Passport No.:
Expiry Date:
Address of
correspondence:
Telephone [Office]:
E-Mail:
Telephone [Home]:
Fax No.:
Present Post:
Basic Salary:
Other Emoluments and Allowance etc:
Period of Notice before Reporting for Duty in Brunei:
Attach
passport-size
photograph
here
Faculty/School/Department:
Duties:
Current Position of
Responsibility [e.g. Head of
Department]:
Previous Posts and Responsibilities in this Institution:
Name of Institution
Nature of Employment
Name of Institution
Nature of Employment
Other Employers:
Positions held
Supervision Experience: Please indicate and provide list of supervision at undergraduate level (such as final year
projects) and postgraduate level (Masters degree and PhD students)
[Use additional sheet if necessary]
LANGUAGES
Fluent
Written Ability
Good
Fair
Fluent
Spoken Ability
Good
Fair
Malay
English
Arabic
Others:
FAMILY PARTICULARS
Children Name
Date of Birth
Sex
1.
2.
3.
4.
Applicants Spouse [Indicate briefly, if you wish your spouses occupation and qualifications and possible
employment interest in Brunei [this does not imply that any such employment is available].
Full Name :
REFEREES
Give details of three referees [including position and qualifications], stating whether they may be contacted at this
stage. Please include telephone, fax numbers and email address.
1.
2.
3.
I declare that the particulars in this application and the attached sheets hereto are true to the best of my knowledge
and belief, and that I have not wilfully withheld any material fact.
Signature :
Date:
Notes
(1) A letter of application and any further details may be attached.
(2) Attach a recent photograph to each copy of this application form.