PRIVATE & CONFIDENTIAL

CF701/2

APPLICATION FORM FOR EMPLOYMENT

Photograph
Position Applied:

Expected Salary:

Notice Period:

HOW DID YOU HEAR ABOUT THIS VACANCY?

Jobstreet LinkedIn Family / Friends Others; Please specify: _________________

PERSONAL PARTICULARS (please tick the box ☒ )

Name (as per Identity
Card)

Mobile
Current Address
Home Tel
Email Address
NRIC / Passport No
Date of Birth
& Expiry Date

☐ Yes ( Please specify: ☐ B, ☐ B2, ☐ D, ☐ E )

Driving License
☐ No
Nationality Religion Race

Marital Status : ☐ Single ☐ Married ☐ Divorcee / Widower Gender ☐ Male ☐ Female

Occupation
Spouse Name :
Employer
Name :
Relation :
Emergency Contact
number Name :
Relation:

LANGUAGE PROFICIENCY
Basic “B” Basic “B” Basic “B”
Malay Intermediate “I” English Intermediate “I” Others Intermediate “I”
(please specify)
Fluent “F” Fluent “F” Fluent “F”
Written ☐ ☐
Spoken ☐ ☐

FORM NO. CF701/2 – ISSUE 2

PAGE 1 OF 6
EDUCATION / PROFESSIONAL CERTIFICATION
School/University/College/Professional Year
Qualification Attained / Grade (CGPA)
Certification Attained

COMPUTER LITERACY (Please indicate “B” for basic. “I” for intermediate and “A”
for Advance

Software Proficiency Certification (if any)

PROFESSIONAL MEMBERSHIP & PRACTICING LICENSES

Name of Professional Body Member Since Category of Membership / Position

Board of Engineering Malaysia (BEM)

IEM Institute of Engineering Malaysia (IEM)

Construction Industry Development Board

(CIDB)
Others

TRAINING COMPLETED

Courses / Training Program Name of Training Provider Year Attained

CURRENT AND PAST EMPLOYMENT

Company Name
and Address
Nature of Business /
Industry

From (MM/YY) To (MM/YY)

Reports to
Position Held
(Designation)
Reason for Leaving

FORM NO. CF701/2 – ISSUE 2 PAGE 2 OF 6

Brief Description of
Responsibilities &
Achievements

Basic Salary
Current Package Fixed
Allowance
Current Benefit
Company Name
and Address
Nature of Business /
Industry

From (MM/YY) To (MM/YY)

Reports to
Position Held
(Designation)
Reason for Leaving

Brief Description of
Responsibilities &
Achievements

Basic salary
Remuneration Fixed Allowance
Package

Company Name
and Address
Nature of Business /
Industry

From (MM/YY) To (MM/YY)

Reported to
Position Held
(Designation)
Reason for Leaving

Brief Description of
Responsibilities &
Achievements

Remuneration Basic salary

Package Fixed Allowance

RELATIVES / FRIENDS WORKING IN TIMELESS GREEN SDN BHD AND

MINCONSULT
Known For
Name Position Relationship (years)

FORM NO. CF701/2 – ISSUE 2 PAGE 3 OF 6

REFERENCES (inclusive of a supervisor/superior from previous employment)

Name Known For

Position & Employer Relationship Contact No
(years)

DECLARATION OF CANDIDATE
1. Can we contact your previous employers for reference checks? ☐ Yes ☐ No
2. Can we contact your present employers for reference checks? ☐ Yes ☐ No
3. Can we have your consent to conduct a background check on you to verify the ☐ Yes ☐ No
information that you have provided in this form?
4. Are you employed on a full-time, part-time or contract basis or engaged in private work
other than your present job stated in this form? If yes, please state the name of the ☐ Yes ☐ No
company and position held.
Company Position Held

5. Are you holding a directorship position in any listed or unlisted companies? If yes, ☐ Yes ☐ No
please provide details.
Company Position Held

6. Are you currently holding position in any social or professional organization(s)? If yes, ☐ Yes ☐ No
please provide details.
Organisation Position Held

7. Have you been dismissed from employment due to misconduct? If yes, provide details ☐ Yes ☐ No

Details

8. Have you been charged in any court of law? If yes, please provide details. ☐ Yes ☐ No

Details

9. Have you been or are you suffering from any prolonged illness, physical impairment or ☐ Yes ☐ No
disease, under any medical condition and or underwent surgery?

Details

10. Have you been declared a bankrupt/ charge under Bankruptcy Act ? CCRIS/ CTOS? ☐ Yes ☐ No

Details

11. Have you convicted of crime in any country ? ☐ Yes ☐ No

Details

12. Have you involved in any lawsuits and do you have any pending? ☐ Yes ☐ No

Details

13. Have you involved in any labour / industrial relations cases? ☐ Yes ☐ No

Details

FORM NO. CF701/2 – ISSUE 2 PAGE 4 OF 6

 14. In default of any loans ? (HP? Housing/ personal etc) ☐ Yes ☐ No

Details

15. For Female candidates only. Are you pregnant as at the date of application? ☐ Yes ☐ No

Details

16. Have you presently or previously any undesirable habits such as :

a. Excessive Alcohol ☐ Yes ☐ No
b. Drugs ☐ Yes ☐ No
c. Gambling ☐ Yes ☐ No
d. Others, please specify ☐ Yes ☐ No
17. Are you prepared to serve the Company in :-
a. Peninsular Malaysia ☐ Yes ☐ No
b. Sabah / Sarawak ☐ Yes ☐ No
c. Overseas ☐ Yes ☐ No
18. Are you prepared to work overtime:
a. After office hours ☐ Yes ☐ No
b. Saturdays / Sundays ☐ Yes ☐ No
c. Public Holidays ☐ Yes ☐ No
19. Have you registered for Covid-19 Vaccination? ☐ Yes ☐ No

st
If yes: Date for 1 dosage: ________________
nd
Date for 2 dosage: ________________
Details
If no : Please specify : ____________________

DATA PROTECTION NOTICE please tick the box ☐ )

☐ I confirm and agree for TIMELESS GREEN to use and store my data for the purpose of recruitment, in accordance
with the terms of the privacy policy.

DECLARATION OF CANDIDATE (please tick the box ☐)

All information provided by me in this application form together with all the attachments hereto are true and accurate. I
understand and accept that providing false and inaccurate information shall be grounds for immediate dismissal.

Name Signature Date

FORM NO. CF701/2 – ISSUE 2 PAGE 5 OF 6

PERSONAL DATA – NOTICE AND CONSENT
CANDIDATE’S AUTHORISATION NOTICE

The Personal Data Protection Act 2010 (“Act”) has been implemented to regulate the processing of personal data
uncommercial transactions. This Personal Data Protection Notice (“Notice”) has been issued by Timeless Green Group
in accordance with the Act to provide you with information on your personal data and/or sensitive personal data which
may be processed by us and the manner in which we are doing so. For the purpose of this Notice, "Personal Data" and
“Sensitive Personal Data” shall have the meaning as ascribed to it in the Act. Unless otherwise stated, all capitalized
terms herein shall have the same meaning as prescribed to it under the Act.

The requested information shall be used in our assessment of your suitability to meet the requirements of the
position available, for administration, management, assessment and analysis, compliance, training, audit, and other
purposes allowed by law and which may be disclosed to our service providers and agents, and/ or shared with the
Timeless Green Group of Companies for these purposes, or if required to be disclosed by regulatory or statistical
authorities, agencies or bodies. The information requested (except those marked with an asterisk (*)) is necessary
for the consideration of your application for the position available. Failure to provide the 6required information or
providing inaccurate information could result in rejection of your application.

If your application is rejected, we will keep your information for six (6) months according to legal requirements and
may contact you if there are any other suitable job opportunities within the Group. If you do not wish for us to
process the information that you have provided or contact you for this purpose, please tick here
…………………………………………

If your application is accepted, all information provided by you will become part of our employee record and will be
retained by us in the manner stated in the first paragraph above.
You have the right to ask for a copy of the information we hold on you (for which we may make a small
administrative charge). You may request to correct unintentional inaccuracies in the information you have provided.
If you cease to be an employee in the Timeless Green Group of Companies, you may request that we cease
processing the information that you have provided. All requests should be directed to the Human Resources
Department in writing.

The information requested and marked with an asterisk (*) may not be necessary at this stage of your application; it
is only recommended that you provide it so that you will not be asked for the information at a later stage of your
application. In the event that the information is given by you now (or later as the case may be), it will be taken as
your explicit consent for us to collect and process the information in the manner stated in the first paragraph above.

I confirm that I have read, understood and accepted the terms and conditions stated in this Candidate Authorisation
Notice in relation to my job application, and as the case may be, my subsequent employment at the Timeless Green
Group of Companies.

I authorise representatives of the Timeless Green Group of Companies to collect, process and/or disseminate the
information as stated in the first paragraph of the Candidate’s Authorisation Notice.

I further consent to the Company conducting credit checks on me and to use the information as may be necessary in
their consideration of my application and subsequent employment.

I undertake that I will not hold Timeless Green Group of Companies liable for any fraudulent information that I have
provided and further I confirm that I will bear all such costs as incurred as a result of my action. I also confirm that
the Minconsult Group of Companies shall not be held liable and/or responsible in anyway whatsoever whilst
processing the information that I have provided in this Application for Employment Form and to the Human
Resources Department.

Name Signature Date

FORM NO. CF701/2 – ISSUE 2 PAGE 6 OF 6