APPLICATION FOR EMPLOYMENT

(Private & Confidential)

Attach
Photo
POSITION APPLIED FOR : _________________________________________

PERSONAL PARTICULARS
* Dr/Mr/Mrs/Miss/Mdm Alias/Other Name (If any)
Full name as in Identity card/Passport (Please underline surname/family name)

Residential Address Telephone No.

Home :
Mobile Phone/Pager*:
Office :
Email:
Home Country Address (if different from residential address) Telephone No.
Home :
Mobile Phone:
Date of Birth (dd/mm/yyyy) Place of Birth (Country/City/State) Nationality

*Identity Card/Permanent Resident/Passport No. For PR holders, state date ofRace/Dialect

*Old Identity Card No.(where compulsory in country of employment) Religion

Marital Status (Single/Married/Divorced/Others-please specify) Gender (Male / Female) Driving Licence : Yes / No *
Class :
Possess own vehicle: Yes / No *

EDUCATION
School/Institution Course/Majors From To Highest Qualification

PROFESSIONAL QUALIFICATIONS (Post Graduate Studies/Certificate/Diploma)

Name of Institution From To Qualification

SCHOLARSHIPS/MERIT AWARDS
Type of Scholarship/Award Value From To

Form PF-01 (01/01)

 * Delete if inapplicable

Form PF-01 (01/01)

PRESENT & PAST EMPLOYMENT (Please start with your latest employment)
1 Position Held Date Salary (state currency type)
From(mm/yyyy) To (mm/yyyy) Starting Last Drawn
Employer

Address Type of Industry

May we contact this employer? Yes / No * Telephone No. :
Contact Person & Position
Reason for Leaving

Responsibilities

2 Position Held Date Salary (state currency type)

From(mm/yyyy) To (mm/yyyy) Starting Last Drawn
Employer

Address Type of Industry

May we contact this employer? Yes / No * Telephone No. :
Contact Person & Position Held
Reason for Leaving

Responsibilities

3 Position Held Date Salary (state currency type)

From(mm/yyyy) To (mm/yyyy) Starting Last Drawn
Employer

Address Type of Industry

May we contact this employer? Yes / No * Telephone No. :
Contact Person & Position Held
Reason for Leaving

Responsibilities

4 Position Held Date Salary (state currency type)

From(mm/yyyy) To (mm/yyyy) Starting Last Drawn
Employer

Address Type of Industry

May we contact this employer? Yes / No * Telephone No. :
Contact Person & Position
Reason for Leaving

Responsibilities

REMUNERATION
Expected Salary On Successful Appointment Earliest Possible Date for Appointment
 Other form of
Compensation (if any)

Telephone No. :

Other form of
Compensation (if any)

Telephone No. :

Other of
Compensation (if any)

Telephone No. :

Other form of
Compensation (if any)

Telephone No. :
Earliest Possible Date for Appointment
PARTICULARS OF PARENTS, SIBLINGS, SPOUSE AND CHILDREN
Name Relationship Date of Birth Occupation Employer/School
1

GENERAL INFORMATION
Language Skills
Spoken
Written

Computer Literacy
Software Applications
Operating System / Language

Professional Membership / Association

Name of Institute Country Membership Type

National Service
National Service Status : Vocation : _______________

Not Applicable / Active Reservist / Exempted / Completed Reservist *

Date of Enlistment : _________________ Run-Out Date : ___________________ Rank : ________________

Hobbies
Indoor Activities
Outdoor Activities

REFEREES (Please provide two referees who know you in your employment or private life (non-relative) and to whom reference may be made)

Name Address Occupation Contact Number

EMERGENCY CONTACT
Name Relationship Address Contact Number
* Delete if inapplicable
Vocation : ________________
DECLARATION OF APPLICANT (If your answer is 'yes', please give details in the space provided)
1 Are you an undischarged bankrupt? Yes / No *

2 Have you ever been charged, convicted in any court of law or Yes / No *
detained under the provisions of any written law?

3 Have you ever suffered any physical disabilities, illness or me Yes / No *

illness e.g. diabetes, tuberculosis, epilepsy, high blood pressure,
etc.?

4 Have you had an operation or been treated for any illness dur Yes / No *
the past 5 years?

5 Are you in debt? Yes / No *

6 Have you any obligations under promissory note either as pri Yes / No *
or surety?

7 Have you ever been dismissed or suspended from any emplo Yes / No *

8 Have you ever been employed by any organisation of the Yes / No *

Jebsen & Jessen Group of Companies?

9 Do you have any friends or relatives working for our Compan Yes / No *

Declaration

I declare that the above information and documents attached hereto are true and correct. I
understand that any false answers or statements made by me on this application or any
supplement thereto will be sufficient grounds for immediate termination of my services.

____________________________________ ________________________
Signature of Applicant Date of Application

FOR OFFICIAL USE

Date of Interview Interviewed By

Source :
Advertisement / Referred By Agencies / Staff Recommendation *
Comments

Position Offered : Department : Supervisor :

Approved For Hire By Grade Starting Salary Starting Date

* Delete if inapplicable