EMPLOYMENT APPLICATION FORM

POSITION APPLIED : SERVICE ENGINEER

PASSPORT
SOURCE : Recruitment Company/ Job Street / Website / Our Staff Recommendation SIZE

(Name of Staff: ________________________________________________)

PHOTO

(Others:_____________________________________________________)

PERSONAL DATA

FULL NAME (as in NRIC) AMMIRRUL IKHMAL BIN AHMAD DAUD NRIC NUMBER 930110-10-6027
NO 105, JLN ANDALAS
Block B-9-19, Baiduri Court
1, TAMAN ANDLAS Apartment , jalan BP 14, Bandar
PERMANENT ADDRESS 71700, MANTIN,
CORRESPONDENCE ADDRESS Bukit Puchong 2, 47120
NEGERI SEMBILAN Puchong, selangor

TELEPHONE NO. (HOME) MOBILE PHONE NO. 017-6855308

DATE OF BIRTH 10/01/1993 GENDER MALE
PLACE OF BIRTH HOSPITAL BANTING NATIONALITY
SELANGOR

RACE RELIGION

MARITAL STATUS NUMBER OF CHILDREN

EPF NO INCOME TAX FILE NO.

BLOOD TYPE

FAMILY INFORMATION (PARENT, SIBLING, SPOUSE, CHILDREN)

FULL NAME (as in NRIC/Passport) RELATIONSHIP AGE OCCUPATION PLACE OF WORK

EMERGENCY CONTACT

NAME RELATIONSHIP HOME TELEPHONE NO. MOBILE PHONE NO.

Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997

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 EMPLOYMENT HISTORY

DATE OF LAST DRAWN

CURRENT / PREVIOUS EMPLOYER DATE JOINED STARTING POSITION LAST POSITION REASON FOR LEAVING
RESIGNATION SALARY

EXPECTED SALARY DATE AVAILABLE

EDUCATION BACKGROUND

YEAR
SCHOOL / COLLEGE / UNIVERSITY HIGHEST QUALIFICATION
FROM TO

LANGUAGE PROFICIENCY & SKILLS

WRITTEN SPOKEN
LANGUAGE PROFICIENCY &
COMPUTER LITERACY
SKILLS
GOOD AVG POOR GOOD AVG POOR

ENGLISH
GOOD

MALAY
AVERAGE

CHINESE
POOR

OTHERS

Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997

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 REFERENCES (Please do not include family members, friends or relatives)

NAME RELATIONSHIP CURRENT POSITION CURRENT COMPANY CONTACT NO.

OTHER INFORMATION
Do you suffer any physical defects or have you recovered from serious illness?
YES NO
If yes, please explain __________________________________________
Have you ever been convicted in court of law?
YES NO
If yes, please explain __________________________________________
Have you ever been discharged or suspended from service of employment?
YES NO
If yes, please explain __________________________________________

Are you currently pregnant or planning a pregnancy in the coming 6 months period? YES NO

Are you willing to work overtime, shift hours, during weekend and Public Holiday? YES NO

Are you willing to be transferred to other country or Department? YES NO

Any of your family or relative working with our company?

YES NO
Is yes, please state the name of the employee:__________________________________

I, hereby agreed and authorized the Company to direct bank in my monthly salary into my bank account. YES NO

Can we contact your previous employer for a reference check?

YES NO
If no, please state your reason ____________________________________________
Do you have any type of driving license?
YES NO
Please select: Car / Motor / Special Car License

DECLARATION

I declare that all information given by me in this application for employment is true and correct to the best of my knowledge. I understand that any
misrepresentation or omission of facts will be sufficient cause for cancellation of consideration for employment or dismissal from the Company's
service of employment.

Signature : Date :

Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997

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 FOR OFFICE USE

RATING
PERSONAL ATTRIBUTES 1 2 3 4 5 POINTS REMARKS
POOR FAIR AVG GOOD EXC
APPEARANCE

PERSONALITY

ACADEMIC QUALIFICATION

COMMUNICATION ABILITY

WORKING EXPERIENCE

SKILLS ACQUIRED

TOTAL

RECOMMEND FOR 2ND INTERVIEW ACCEPTED KIV REJECTED

REMARKS :

INTERVIEWER NAME : DATE :

FOR MANAGEMENT USE

EMPLOYMENT PACKAGE DETAILS CHECKLIST (FOR HR USE)

COMMENCEMENT DATE : ________________________ 1. I/C PHOTOSTATE COPY

POSITION : ________________________ 2. PASSPORT SIZE PHOTO

DEPARTMENT : ________________________ 3. RESUME/ EDUCATIONAL CERT DOCUMENT

BANK ACCOUNT NO. : ________________________ 4. BANK A/C PHOTOSTATED

BASIC SALARY : ________________________ 5. LATEST MONTH SALARY SLIP COPY

OTHERS (1) : ________________________ 6. DRIVING LICENSE COPY

OTHERS (2) : ________________________ 7. UNIFORM ARRANGEMENT

TOTAL : ________________________

Interviewed By: Verified By: Reviewed By: Final Approved By:

Interviewer Head of Department HR Department

Name : Name : Name : Name :

Date : Date : Date : Date :

Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997
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