ESCAPISM Job Application Form
PLEASE COMPLETE ALL SECTIONS IN FULL.
You may enclose a CV in support of your application.
Expected
Position applied for:
Salary:
Where did you see this post advertised?
Available to take up employment (date):
1. Personal details
Title: (Please circle) Prof Dr Mr Mrs Miss Ms Other (Please state):
Surname: Forenames:
City:
Address:
Post code:
Telephone no.: (Home) (Mobile)
Email: Nationality:
2. Academic and other qualifications
Schools attended (High school, Dates (mm/yy)
Examinations (subjects/results)
College/University) From To
Further education, training and
From To Examinations (subjects/results)
professional qualifications
Please continue on a separate sheet if necessary
3. Previous employment (please include details of your most recent employment here, then give
details of previous roles, working backwards from the most recent). PLEASE PROVIDE
EXPLANATION FOR ANY GAPS IN EMPLOYMENT. Continue on a separate sheet if necessary.
Present/most recent employer:
Start date:
(mm/yy)
Address:
End date:
(mm/yy)
Current
Job title:
salary:
Duties/
responsibilities:
Reason for
seeking new
employment:
Previous employer:
Start date:
(mm/yy)
Address:
End date:
(mm/yy)
Job title:
Duties/
responsibilities:
Reason for
leaving:
Previous employer:
Start date:
(mm/yy)
Address:
End Date:
(mm/yy)
Job title:
Duties/
responsibilities:
Reason for
leaving:
Please continue on a separate sheet if necessary
4. General
Interests/hobbies: (give details of pastimes, sports, etc.):
Do you need a work permit to work in Malaysia?: YES/NO
Do you have a full driving licence?: YES/NO
Are there any disabilities which may affect your participation in work? YES/NO
If yes, please describe disabilities: _______________________________________________________
If offered this position will you continue to work in any other capacity? (give details)
Please detail any commitments which may impact on your work obligations. For example, TA,
jury service, pre-booked holidays etc.
Referees will not be approached before interview
Referee 1 Referee 2
Name: Name:
Relationship: Relationship:
Address: Address:
Occupation: Occupation:
Tel no: Tel no:
Email: Email:
I certify that information contained in this application is true and complete. I understand that false
information may be grounds for not hiring me or for immediate termination of employment at any
point in the future if I am hired. I authorize the verification of any or all information listed above.
Signature of applicant: Date:
EMPLOEYER SECTION
Position offered: Induction date:
Letter of
Payrolls details:
appointment signed:
Signature of
Date:
recruiter:
