CONFIDENTIAL

HR-REC-2014-1

SURUHANJAYA KOMUNIKASI DAN MULTIMEDIA MALAYSIA

MALAYSIAN COMMUNICATIONS AND MULTIMEDIA COMMISSION

JOB APPLICATION FORM

(Kindly affix your
latest Passport
size photograph)

Please Note :

Completion of the application form does not ensure employment.

It will be to applicants advantage to answer all questions fully and accurately.

Delete or put Nil where not applicable.

Attach appendix if the space provided is insufficient.

Attach a certified true copy of NRIC, academic certificates and other supporting
documents

All information supplied will be held with strictest confidence.

Position Applied For :

Assistant Director (P4) at Service Quality and Spectrum Operations Division

__________

PERSONAL DETAILS
Name as per NRIC or Passport :
(Mr./Mrs/Miss/Ms)
Email :
Permanent Address:

Correspondence Address:

Telephone No:

Telephone No:
HP / Off No:

NRIC No:

Date of Birth:

Age:

Country/Place of Birth:

Height:

Weight:

Race:

Religion:

Sex (M/F):

EPF No:

SOCSO No:

Income Tax No:

Driving Licence Class: B2, D

Own transport: Car

MARITAL STATUS
Marital Status : Single / Married / Divorced / Widowed
Spouse Name : N/A
NRIC No:

N/A

Company : N/A

Working : YES (

) NO (

Designation: N/A

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Name of Children

HR-REC-2014-1

Sex
(M/F)

Age

Date of
Birth

FAMILY DETAILS
Fathers Name :

Occupation

Mothers Name :

Occupation

School / Occupation

Parents Address :

Name of Brother / Sisters

Sex
(M/F)

Age

Occupatio
n

Name of Firm / School /

University

Do you have any immediate family member or relatives working in any of the Malaysian
Communication and Multimedia Malaysia (MCMC)? (NO) / (YES)

If YES, what is his/her name ? :

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PERSONAL HISTORY
Have you ever been charged or convicted of a criminal offence? If so, for what offence and when?
Do you have any physical disabilities, chronic ailment or handicap? If so, please specify.
Have you ever suffered from any major illness, nervous breakdown or accidents since birth? If so,
please specify.
Have you ever been hospitalized? If so, please state reason and duration.
Are you bonded to serve with any company? If so, please state contract duration.
Do you have any scholarship? If so, please state your sponsor information

EDUCATION
Schools, Colleges and Universities attended (Please attach appendix if necessary)
Name of School, College
Qualification Level
From
To
Result / Grade
and/or University
and Course Name
(Year)
(Year)
(CGPA)

PROFESSIONAL / COMMERCIAL QUALIFICATIONS

Name of Professional / Institute
Course /
Body
Examination Taken

From
(Year)

To
(Year)

Result

EMPLOYMENT RECORD
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Present Employment
Name of Company
Job Title
Address & Telephone No.
Date of Joining
Specific Duties
Briefly Illustrated Your
Department & Reporting
Structure With Job Titles of
Your Immediate Supervisor
& Direct Report
Initial Basic Salary
Additional Allowances and
Bonus, etc (Please Specify)
Name and Designation of
Immediate Superior
Why do you wish to leave
your present employer?

To : Present

Current Basic Salary

Indicate your expected

salary.
Negotiable (Yes / No)

Notice period required by

your present employment?
Previous Employment
Name of Company (1)
Job Title
Address & Telephone No.
Type of Industry
Period

Location
From :

To :

Position and Duties at Time

of Leaving
Briefly Illustrated Your
Department & Reporting
Structure
Initial Salary

RM

Salary at Time of
Leaving

RM

Name and Designation of

Immediate Superior
Reason for Leaving
Name of Company (2)
Job Title
Address & Telephone No.
Type of Industry

Location
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Period

From :

To :

Position and Duties at Time

of Leaving
Briefly Illustrated Your
Department & Reporting
Structure
Initial Salary

Salary at Time of
Leaving

RM

RM

Name and Designation of

Immediate Superior
Reason for Leaving
Have you ever applied to this Commission for employment before?
(NO) / (YES)
If so, please complete the following:
Approximate Dates

LANGUAGE SKILLS
LANGUAGE

Were you called for

Interview? YES / NO

Post Applied For

(LEVEL Excellent, Good, Average, Poor)

LEVEL
SPOKEN

WRITTEN

Bahasa Malaysia
English
Other (1) : ______
Other (2) : ______
HOBBIES AND INTERESTS
(If reading is one of them, name some books/magazine/periodicals you have read lately)

ACTIVITIES
Category

(Please attach appendix, if necessary)

Activities

Level
(School/University/National/International)

Achievement

Sport

Club
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Academic
Oriented

Others

REFERENCES
Note : List 3 persons, not related to you, who are familiar with your character and qualifications
to whom the Commission may refer to for reference check.

Name of Referee

Job Title &

Employer

Address, H/P No. and

Email Address

Relationship

No. of
Years
Acquainted

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DECLARATION
(Read and please tick () to indicate you have fully understanding on the statement below)
I hereby declare that the particulars in this declaration an in any other documents
completed by me and information provided by me in support of my application for
employment in the Commission, and the information provided by me during interviews
in connection with my application for employment in the Commission, are the best of
my knowledge and belief true and correct in every detail.

I understand that any offer of employment to me in the Commission will be expressly on

the basis that the information that I have provided in relation to my application is true
and correct in every detail
I understand that the Commission reserves the right to terminate my service without
notice or compensation at any time should the Commission discover that any of the
said particulars and answers were false, untrue or incorrect at the time of completion of
this form.
I hereby undertake to notify the Commission immediately should the particulars
supplied above be changed in any way in future.
I understand that any information provided on this Declaration may be checked by the
Commission with the relevant authorities or sources
Signature of Applicant :

Name (In Block Letters) :

Date

NRIC No :

PLEASE RETURN THIS FORM TO:

Suruhanjaya Komunikasi dan Multimedia Malaysia
Malaysian Communications and Multimedia Commission
MCMC Tower 1
Jalan Impact, Cyber 6
63000 Cyberjaya
Selangor Darul Ehsan
Malaysia
Tel: +60 3 8688 8000
Fax: +60 3 8688 1000
Email : recruitment@cmc.gov.my
Website : www.mcmc.gov.my

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SUPPORTING INFORMATION Qualities and skills

Please answer the following questions, providing examples as required. Try as much as
possible to give examples from an employment or academic work background. However,
if you cannot think of an example from a work background, try not to leave the section blank.
Instead, use an example from your University, College or personal life. Please provide the name
and contact details of a colleague, etc who could corroborate your statement.
1. What was the most challenging project that you have ever been involved with and
how do you think your influences affected the outcome?

2. What was the most effective team you have worked in?

3. Think of a time when you were so stretched by a project or an assignment, that you
felt that you might not have been able to complete it. How did you cope? What was
the final outcome?

Extra:
Please highlight any of your skills that would be an asset to the Commission. (IMPRESS
US!)
(Use separate sheet if necessary.)

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