BE STEM READY SDN BHD

No. 1-1, Jalan USJ10/1D

Subang Jaya
47620 Selangor.

JOB APPLICATION FORM

PLEASE READ THESE INSTRUCTIONS CAREFULLY

1. This form is to be completed before the interview session.

2. Do not leave any item blank. If it is not applicable to you, please indicate
"N/A".
3. Please attach photographed colored copy of your NRIC, driving license
and photograph of yourself.
4. Please attach photocopies of all your educational certificates & last 3
months salary slip and present the original certificates & salary slip during
interview.

Position Applied for:

Name
(Please write your name in full as per NRIC)

Permanent Address

House Telephone : Mobile Number:

Office Telephone : Email :

PERSONAL DETAILS

New NRIC Race

Religion Age

Gender Nationality

Place of Birth Date of Birth

Marital Status EPF Number

Income Tax Number SOCSO Number

Mailing Address

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Spouse’s Name Occupation

Spouse’s NRIC Contact Number

Company Name

Company Address

Children’s Particular Name Gender Age

FAMILY’S PARTICULARS
Father’s Name

Mailing Address

Company’s Name Occupation

Mother’s Name

Company’s Name Occupation

Other Family Name Relationship Age Occupation

Member’s
Particulars

Father In-Law’s
Name

Mother In-Law’s
Name

Mailing Address

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 EDUCATION

Type of School Name of School/Institutes Final Year Qualification Obtained Major Subject
Primary
Secondary
High School
College / University
College / University
College / University
Other

LANGUAGE
Please indicate competency in Languages [B = Basic I = Intermediate F = Fluent]
Language / Dialect Spoken Read Written

TRAINING

Training Attended Organiser / Provided Year

MEMBERSHIP OF ORGANISATION (Professional / Social / Sporting / etc.)

Organisation Year

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 EMPLOYMENT HISTORY

Name of Company

Type of Business

Position Held From To

Current Basic Salary Fixed Allowance 1.

Bonus: Contractual 2.

Performance Averaged Commission

Reason for Leaving

Name of Company

Type of Business

Position Held From To

Current Basic Salary Fixed Allowance 1.

Bonus: Contractual 2.

Performance Averaged Commission

Reason for Leaving

Name of Company

Type of Business

Position Held From To

Current Basic Salary Fixed Allowance 1.

Bonus: Contractual 2.

Performance Averaged Commission

Reason for Leaving

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Name of Company

Type of Business

Position Held From To

Current Basic Salary Fixed Allowance 1.

Bonus: Contractual 2.

Performance Averaged Commission

Reason for Leaving

REFERENCES

Name Occupation/Position Contact Relationship Period Known

& Company Number

OTHER INFORMATION

Expected Monthly Salary

Possess Own Transport YES NO License

Availability for Employment

Date Available to Start Work

Hobbies & Social Activities

EMERGENCY CONTACT (Compulsory)

Name Address Contact Number Relationship

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 DECLARATIONS

1. Have you been found guilty in any COURT OF LAW or detained under any written laws?

No Yes (If yes, please give details)

2. Have you ever been declared BANKRUPTCY or charged under BANKRUPTCY ACT?

No Yes (If yes, please give details)

3. Have you ever been convicted of an offence or being suspected of any offence?

No Yes (If yes, please give details)

4. Are currently pregnant now or would plan to be a mother in near period?

No Yes (If yes, please give details)

5. Do you currently have any related psychological problem or medical condition which might prevent or
impede you from being able to satisfactorily perform any duties that might require you in the position you
are applying now?

No Yes (If yes, please give details)

6. Have you ever suffered from any major illness or having any surgery operation for past five years?

No Yes (If yes, please give details)

7. Have you ever received any written warning, show cause or been dismissed/resigned due to allegations of
improper conduct or integrity issue or unsatisfactory work performance?

No Yes (If yes, please give details)

8. Have you always been away from work by means of emergency leave and sick leave due to personal issue?

No Yes (If yes, please give details)

9. Have you ever applied or interviewed this Company or its related group of Companies previously?

No Yes (If yes, please give details)

10. Do you have any friends or relatives work in this Company or its related group of Companies?

No Yes (If yes, please give details)

I, ____________________________________, NRIC : ________________________ disclose that all information

provided hereof and attached to this application are true and correct. Any misleading or fraudulent information
shall entail to cancelling of my hiring, or terminate/dismiss my employment without compensation if I am hired. I
shall extend my full co-operation if there is audit investigation carry out.

Signature: Date:

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 FOR OFFICE USE / INTERVIEWER USE ONLY (Confidential)
Comments / Remarks:

Interviewed By :

Name :

Date :

Position Offered :

Monthly Remuneration : Ringgit Malaysia (RM)

Monthly Allowance : Ringgit Malaysia (RM)

Commencement of Work :

Approved By:

Name :

Date :

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