HUMAN RESOURCE Document No.
SB-HR-SOP04-F02
Revision NEW
JOB APPLICATION FORM Issue Date 06 SEP 2022
Page 1/6
PRIVATE & CONFIDENTIAL
Paste Photo
Instructions Here
1. All sections must be completed and please write “NA” if not applicable.
2. Please tick () in the appropriate box.
3. Please attach all relevant copies of certificates/testimonials where applicable.
Section A (Position Applied For)
Lorry Driver Recommended by:
Section B (Personal Particulars)
Name (as in NRIC/Passport): Muhammad Jamil Bin NRIC No: 85****-01-****
Correspondence Address: No 21A, Jalan *********,Kampung Sepakat Jaya, 81300 [Link]
Permanent Address: No 21A, Jalan *********,Kampung Sepakat Jaya, 81300 [Link]
Email address:******@[Link] Nationality: Malaysian
Handphone No: 01*-******** House No: Office: -NA-
Date of Birth: **** . ****.1985 Age: 40 years old Place of Birth: Muar,Johor.
Marital Status: Single Married Others: Driving License: Y N Class: GDL
T-shirt size: S M L XL others: Waist size: S M L XL others: 36 Shoe size (cm): 27.3cm
Section C (Family Particulars)
Name of Employer /
Name Relationship Age Occupation / Student
Institution
Siti Suhaila Bt Pungot Wife 38 Retail Associate Adidas Malaysia Sdn. Bhd.
Adam Iman B Muhammad
Son 16 Student SMK
Jamil
Zahra ImanninaBt
Daughter 15 Student SMK
Muhammad Jamil
Keysha Imani Bt
Daughter 13 Student SMK
Muhammad Jamil
Aathif Faaeq Iman B
Son 5 Student PASTI
Muhammad Jamil
HUMAN RESOURCE Document No. SB-HR-SOP04-F02
Revision NEW
JOB APPLICATION FORM Issue Date 06 SEP 2022
Page 2/6
Section D (Education - Highest Qualifications) Begin with the latest qualification, including professional qualifications.
Year Obtained
Education Level Name of Institution Qualification (mm/yy)
Certificate /High School Sekolah Teknik Muar Sijil Pelajaran Malaysia
(Vokasional) (SPMV)
Certificate/Secondary Sekolah Menengah Kebangsaan Bukit Penilaian Menengah Rendah
School Gambir,Muar (PMR)
Certificate/Primary School Sekolah Rendah Bukit Gambir Ujian Penilaian Sekolah Rendah
Section E (Linguistic Ability) Please indicate appropriately: Excellent / Good / Average / Poor
Other Languages
Language English Malay
Spoken
Written
Section F (Employment History)
Current/Most Recent Employer’s Name:
Designation: From (mm/yy): To (mm/yy):
Summary of job function:
Last Drawn Basic Salary: Allowances:
Expected Salary: Notice Period:
Reasons for Leaving:
HUMAN RESOURCE Document No. SB-HR-SOP04-F02
Revision NEW
JOB APPLICATION FORM Issue Date 06 SEP 2022
Page 3/6
Organization Chart - Please draw your position in the organization chart at the present / previous employer.
Logistics Department Organization Chart
Employment History
From (mm/yy) To (mm/yy)
Employer’s Name Designation Reasons for Leaving
HUMAN RESOURCE Document No. SB-HR-SOP04-F02
Revision NEW
JOB APPLICATION FORM Issue Date 06 SEP 2022
Page 4/6
HUMAN RESOURCE Document No. SB-HR-SOP04-F02
Revision NEW
JOB APPLICATION FORM Issue Date 06 SEP 2022
Page 5/6
Section G (General Declarations)
PLEASE ANSWER THE FOLLOWING QUESTIONS WITH A TICK () DETAILS
YE N (WHERE APPLICABLE)
IF “YES”, GIVE DETAILS IN THE RIGHT-HAND COLUMN OR SEPARATELY
S O
1. Are you willing to perform shift duties and work on weekends including
public holidays?
2. Have you been or are you suffering from any physical impairment or
disease that can affect your work or attendance to work?
3. Are you presently on medication (excluding supplements) because of your
health condition?
4. Have you ever been charged with any offence or convicted by any Court or
detained by the authorities under the provisions of any law in any country?
5. Do you give consent to us to conduct pre-employment/background
screening which includes personal information, education, financial
standings, CCRIS and employment history? If No, please state the reasons.
If Yes, please fill up the Applicant’s Certificate and Release (Consent Letter
as attached).
6. Are you in the process or application for any court or civil proceedings?
7. Are you bankrupt or have you ever been made bankrupt?
8. Have you been the subject of any current or past or pending & / or in
progress investigations, not limited to government authorities or with
past employers?
9. Have you ever been dismissed or terminated or received any disciplinary
action in your previous employment?
10. Is there any other adverse information that we should be aware of in
considering your suitability for employment?
11. Do you have any friends or relatives working in our Company / Group? If
Yes, please furnish details.
12. Are you involved in any business undertakings? (e.g. Directorship,
Partnership, etc.)
13. Do you give consent to us to contact your previous employers for a reference
check? If No, please state the reasons.
14. Have you been tested positive for Covid-19? If Date: -NA-
Yes, please state the date.
15. Have you received the 2 doses of Covid-19 Vaccination? If Dose 1:
Yes, please state the date. Dose 2:
Section H (References)
Please provide at least 2 references (not relatives or family members but ex-superiors from your previous employment).
Years
Name of Referee Profession/Occupation Name of Employer Contact No. & E-mail
Known
Supervisor (Logistics) Gardenia Malaysia
HUMAN RESOURCE Document No. SB-HR-SOP04-F02
Revision NEW
JOB APPLICATION FORM Issue Date 06 SEP 2022
Page 6/6
Section I (Declaration)
I hereby declare to the following declarations.
i. I declare that all particulars on this application are true and correct to the best of my knowledge. I understand
and accept that if there has been any misrepresentation or omission of facts relating to this application or if I
have willfully suppressed any material facts, the Company reserves the absolute right to take disciplinary action
against me including immediate dismissal from the Company’s service even if I have already been employed.
ii. Should there be any change(s) in the status and/or truth of the declarations above, it is my sole responsibility
and duty to inform the Company accordingly at any relevant time whether prior to and/or during my
employment with the Company. The Company reserves the absolute right to take any disciplinary action against
me including immediate dismissal from the Company’s service if there should be any change(s) in the status
and/or truth of the general declarations made above.
iii. With this application and the declarations I make herein, I accept that it will form an integral part of the Letter of
Appointment that I will be signing and/or have signed.
Signature of Applicant: Date of Application: 25 April 2025