NESTCON INFRA SDN. BHD.

(556959-W)
NESTCON BUILDERS SDN. BHD. (1063335-M)

JOB APPLICATION FORM

Position / Jawatan Admin Assistant cum Receptionist PHOTO

Name as per NRIC /

Siti Rohani binti Yusof
Nama seperti dalam K.P.
Nationality / Race / Gender / Jantina Religion /
Malaysia Malay Islam
Warganegara Keturunan ☐ Male / Lelaki ☐x Female / Perempuan Agama
NRIC No. / Date of Birth /
020228-06-0148 Age / Umur 21 28-02-2002
No. Kad Pengenalan Tarikh Lahir
Present Address / Alamat Terkini

B-12-8 Kinrara Mas Condominium Jalan Mas 1, Bukit Jalil 58200 Kuala Lumpur

Permanent Address / Alamat Tetap

No 202 Blok 9 Felda Terkis Jengka 22 Bandar Pusat Jengka 26400 Maran, Pahang

Home / - Mobile No. /

Contact No. / No. Telefon 016-5341330
Rumah Telefon Bimbit
Email address / Alamat Emel [email protected]
Marital Status /
Taraf Perkahwinan
x Single / Bujang
☐ ☐ Married / Kahwin ☐ Divorced / Bercerai ☐ Widowed / Janda/Duda

EDUCATION / PENDIDIKAN (Please enclose a copy of all relevant certificates / Sila lampirkan salinan sijil yang berkenaan)
Year Attended /
Name of Institute / Nama Institut Final Achievement / Pencapaian Akhir
Tahun Pengajian
Cybernetics International College of
2020-2022 CGPA : 3.22
Technology

KNOWLEDGE OF LANGUAGES / PENGETAHUAN BAHASA

Speaking / Bertutur Understanding / Pemahaman Reading / Membaca
Language
/ Bahasa Excellent / Good / Fair / Excellent / Good / Fair / Excellent / Good / Fair /
Sangat bagus Bagus Sederhana Sangat bagus Bagus Sederhana Sangat bagus Bagus Sederhana
Malay x x x
English x x x

WORKING EXPERIENCE / PENGALAMAN BEKERJA (Please enclose a copy of Resume / Sila lampirkan Resume)
Date Employed / Tempoh Berkhidmat Last Drawn Salary /
Name of Employer / Nama Majikan Position / Jawatan
From To Gaji Akhir
Mail Boxes ETC Feb 2020 April 2020 Customer Service

DRB-HICOM Ez-Drive Sdn Bhd Aug 2022 Dec 2022 Fleet Officer

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 REFERENCES / RUJUKAN
Name / Nama Contact No. / No. Telefon Company Name / Nama Syarikat Occupation / Jawatan

Muhammad Hafiz 013-9641207 DRB-HICOM Ez Drive Sdn Bhd

Do you agree to our making enquiries of your present employer?

x Yes
☐ ☐ No
Adakah anda setuju kami membuat pertanyaan dengan majikan anda sekarang?
Expected Monthly Salary / Gaji Bulan yang dipohon RM 2,000
If appointed, when can you start work? / Anytime
Jika terpilih, bilakah anda boleh bermula bekerja?

HEALTH DECLARATION / PENGAKUAN KESIHATAN

YES NO
1. Are you colour blind? ☐ ☐x
2. Any serious or major illness have you suffered or had been treated for any of the following?
a) Chronic cough, spitting of blood, asthma, hay fever, pleurisy, tuberculosis or any other disease of the respiratory
system? ☐ x
☐
b) High or low blood pressure, heart disease, chest pain, heart attack, shortness of breath, palpitation or heart
disorder? ☐ x
☐
c) Epilepsy, fits, dizziness, mental or nervous disorder? ☐ x
☐
d) Diabetes, sugar or blood in urine, kidney, colic or hernia? ☐ x
☐
e) Disease of the eyes, ears, nose or throat? ☐ x
☐
f) Arthritis, sciatica, rheumatism, back, spine, bone, joint, muscle or skin disorder? ☐ x
☐
g) Ulcer or disorder of the stomach, intestines, haemorrhoids or rectal disorder? ☐ x
☐
h) Gall bladder stone or liver disease or any type if hepatitis? ☐ x
☐
i) Cancer, tumour or growth of any kind of any organ system? ☐ ☐
x
j) Anaemia, Thyroid disorder (such as Goitre) or Rheumatic Fever? ☐ x
☐
k) AIDS or AIDS related conditions? ☐ ☐
x
l) Others (please declare):
3. Have you been hospitalized in the past? If yes, when was it? Year ☐ x
☐
Diagnosis:

I hereby certify that all of the statements in this application are true and correct to the best of my knowledge and any false information
wilfully given shall be sufficient reason to dismiss me from the service.
Dengan ini saya mengesahkan bahawa semua penyataan dalam permohonan ini adalah benar dan betul sepanjang pengetahuan saya dan
sebarang maklumat palsu yang sengaja diberikan adalah alasan yang mencukupi untuk menghentikan perkhidmatan saya.

Applicant Signature /
Date / Tarikh 16/1/2023
Tandatangan Pemohon

Name / Nama Siti Rohani binti Yusof NRIC / No. KP 020228-060148

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 For Office Use Only
Interviewed by, Approved by,

Name & Signature Name & Signature

Date Date
Appointment is ☐ Successful ☐ Unsuccessful ☐ KIV

Company ☐ Nestcon Group ☐ Nestcon Infra ☐ Nestcon Builders

Position Offered

Employment Type ☐ Permanent ☐ Contract, duration : Month

Accepted Monthly Salary RM Date of Commencement

Work Location / Project Report To

Remarks

☐ Company Car
☐ Petrol Card
☐ Laptop
☐ Desktop
☐ Business Card
Perks and Working Tools
☐ Walkie-Talkie
☐ Safety Vest
☐ Others, please specify:

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