APPLICATION FORM FOR EMPLOYMENT

(Please furnish one recent photograph, photocopy of Identity Card and certificate(s).

DATE OF INTERVIEW : …………………………

POSITION APPLIED FOR : …………....……………..…………………………………

(A) PERSONAL PARTICULARS

Full Name : …………………….…………..…...………………………………………………………………………….

H/P No.: ……………………………………

NRIC No. (New) : ……………………….…….……..….………………….………………………………………….

(Old) : ………………...……………………….

Permanent Address : ………………..………………………………………………………..……………………

Tel. No. : ………………………….…………..

………………………..…………………………………………………………..………………………………………………………………………

Current Address : ……………………...………………………………………………………..……………………

Tel. No. : ……………………………………..

………………………..…………………………………………………………..………………………………………………………………………

Present Company's Address : ……………………………………………..…………..……………………

Tel. No. : ……………………………………..

………………………..…………………………………………………………..………………………………………………………………………

Date of Birth : ………...………………. Place of Birth: ……………………………………. Age : …...……………..

Nationality : ………………………….. Marital Status : Single / Married / Divorced No. of Children (if married) : …………..

Sex : Male / Female Race : …………………..

Religion: ……………...………
Height : …..…… (cm) Weight : …………..(kg)

State whether you own any vehicle, motor-bike, etc : ………………...……...……….……………….

(B) QUALIFICATIONS

Period
School / College / University / Professional Certificate, Diploma or Degree obtained
From To

(C) OTHER TRAINING OR EDUCATION COURSES ATTENDED

Name of Institute or Organizer Title of Course or Topic Duration of Course

For Secretary, Stenographer and Typist positions :

Shorthand speed ……………………. w.p.m Typing speed …………………. w.p.m Telex ability : Yes / No
(D) EMPLOYMENT HISTORY (Latest employment on top)

From To
Position Held (pls states Other
No. Employers & Address Tel. No. Duties & Responsibilities Starting Salary Last Salary Reason for Leaving
(Month & Year) (Month & Year) promotion, if any) Allowances

(E) FAMILY MEMBER (I) OTHER INFORMATION

- including parent, spouse, children, siblings 1. If offered a post, how soon you can start work? ………………………………………….
No. Name Relationship Occupation Age 2. Expected salary : ………………………………………..
Negotiable : Yes / No

3. Person to contact in case of emergency .

Name : ………………………………….
Relationship : ……………………………
Tel. No.: ……………...……………

Address : ……………………………………………………………………………………………….

4. Do you have any relative(s) or friend(s) working in this company? If yes, please state

Name : ………...……………………………………. Telephone No. : ……..…………………………….

Position : ……….……...…………………………..

DECLARATION :
(F) LANGUAGE & DIALECT PROFICIENCY (State 'Yes' where Applicable) I hereby declare that to the best of my knowledge and belief, the information given in this Application Form are
true and correct. I also hereby accept that any misrepresentation or ommision of facts will be sufficient
Mother Tongue : ………………………………..
grounds for termination of my employment with the Company, should I be offered employment with the
(insert : Excellent / Good / Fair / Poor in appropriate column) Company. I also hereby authorise you to contact the relevant third parties to verify the accuracy of the
Language / Dialect Read Write Speak information provided herein.

Date : ………………………….. Signature : ………………………………………

[For Human Resource Department Use]

Verifications:
Certificates Latest Payslip Others

(G) EXTRAMURAL ACTIVITIES / HOBBIES

…………….…………………………………………………………………………………………………………………. Remarks :

(H) REFEREES ( Please provide two names )

Particulars 1st Referee 2nd Referee
Name
Tel No
Company & Occupation
Years known