Doc No: GK/F-ADM/14-01

Effective Date: 1/1/2011

Page 1 of 4

APPLICATION FOR EMPLOYMENT CONFIDENTIAL

Position Applied For

A Personal Particulars

Full Name (please writes in Block Letters & Underline surname)

Address (as per IC):

Correspondence Address:

Telephone (H): (HP): (Email):

Sex Male/Female NRIC No.(Old)
Date of Birth NRIC No.(New)
Race Nationality
Religion Place of Birth
Marital Status Passport No.
EPF No.: SOCSO: Income Tax No. :
Driving License : B/B1/B2/B3/D/E/E1/E2 Expired Date

B Education

Academic History Date of Grade /

University/Institute/School name & Location
(Qualification) Completion CGPA

C Other Training

Course Title Institution / Organizer Period

 Doc No: GK/F-ADM/14-01
Effective Date:1/1/2011
Page 2 of 4

D Language Proficiency

Language Spoken Written Language Spoken Written

English Other :( )
Malay Other :( )
Mandarin
Other :( )

E Employment History

Position Held Last Earned Company Name & Location Period

Salary From To

Expected Salary RM Notice/Period required

F Character referees

Name Years known Position Relationship Address /Telephone

May we write to following for a reference?

a. Your present employer Yes/No
b. Your previous employer(s) Yes/No

Do you have any friends/relatives employed by this company? if yes, please state below
Name Position Relationship Department
 Doc No: GK/F-ADM/14-01
Effective Date: 1/1/2011
Page 3 of 4

G Extra-curricular activities/Hobbies/Sport

H 1. Family Information

Name Relation Employer Occupation

2. Spouse Information

Name IC Number Employer Occupation

1 2 3
Number of children Ages of Children

I Other information

Please answer the following questions. If the answer is yes, gives details

1. Have you ever been convicted in a court of law of any country? Yes/No

2. Have you ever been dismissed or discharged from employment? Yes/No

3. Have you ever had, or are you suffering from any physical impairment
/disease/mental illness? Yes/No

J To notify in case of emergency

Name Relationship
Address Telephone
Home
Office
Handphone
 Doc No: GK/F-ADM/14-01
Effective Date: 1/1/2011
Page 4 of 4
K Declaration by applicant
Page 4 of 4

Important : If the company find that you have knowingly made a false declaration
or willfully suppressed facts, your application will be disqualified
or if after employment ,the company reserves the right to terminate
your service without notice.

I, declare that the information given by me in this application is true to the best of my knowledge and that I have not
willfully suppressed any material fact.

Signature of applicant

L For office use only

Interview on by Reject/KIV/Hired

Interview on by
Reject/KIV/Hired

Hired
Department

Position

Commencing
Date

Salary/Allowance

Others

Approved by/
Date