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1. Job Application Form 2019

This document is a job application form that requires candidates to provide personal, educational, and employment history details, along with family information and references. Applicants must also consent to a background check and declare the accuracy of the information provided. The form includes sections for personal details, education, employment history, and a declaration of truthfulness regarding the information submitted.

Uploaded by

Atika Rahman
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
12 views

1. Job Application Form 2019

This document is a job application form that requires candidates to provide personal, educational, and employment history details, along with family information and references. Applicants must also consent to a background check and declare the accuracy of the information provided. The form includes sections for personal details, education, employment history, and a declaration of truthfulness regarding the information submitted.

Uploaded by

Atika Rahman
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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PRIVATE &CONFIDENTIAL

PLEASE AFFIX A
JOB APPLICATION FORM RECENT
PLEASE READ THESE INSTRUCTIONS CAREFULLY PASSPORT-SIZED
1. This form is to be completed before the interview session PHOTOGRAPH
2. Do not leave any item blank. If it is not applicable to you, please indicate N/A .
3. Please attach a copy of your photocopy IC.
4. Please attach photocopies of all your educational certificates & present the original certificates
during the interview.

Position Applied For:


PERSONAL DETAILS
Name:
Chinese Name
(if applicable):
Address:

House Tel: Mobile Tel:


Office Tel Email:
NRIC / Passport: Race:
Religion: Marital Status:
Gender: Date of Birth:
Place of Birth: Nationality:
Height(cm): Weight(kg):

FAMILY DETAILS

Relations Name Age Present/Previous Occupation


Spouse
Children

Father
Mother
Siblings
PRIVATE &CONFIDENTIAL
EDUCATION DETAILS

Type of Year Attended Qualification


Name of School Location
School From To Obtained
Secondary
School
College/
University
College/
University
College/
University
Others

Please indicate competency in language[B=Basic, I=Intermediate, F=Fluent]


Language/Dialects Spoken Read Written

Specify training courses attended


Training Attended Provider Year

Membership of organizations (professional, social, sporting etc.)


Organization Year
PRIVATE &CONFIDENTIAL
EMPLOYMENT HISTORY
Please indicate your employment history beginning with your current/last employer

Name of Company:
Type of Business:

Duration From To

Position Held:

Current/Last Salary:

Fixed Allowances: 1. 2. 3.

Reason for leaving:

Name of Company:

Type of Business:
Duration From To

Position Held:

Current/Last Salary:

Fixed Allowances: 1. 2. 3.

Reason for leaving:

Name of Company:
Type of Business:

Duration From To

Position Held:

Current/Last Salary:

Fixed Allowances: 1. 2. 3.

Reason for leaving:


PRIVATE &CONFIDENTIAL
OTHER INFORMATION
Do you own a car?
Do you own a motorbike?
Do you have a valid driving license?
Have you suffered form or are you currently suffering from any serious illness?
Detail:
Do you have any physical disabilities?
Detail:
Have you been found guilty in any COURT OF LAW or detained under any written laws?
Detail:
When will you be able to start work?
What is your expected salary?
Contact person and telephone number during emergency:
Name: Tel No.

REFEREES
Please provide names of 2 persons
Name: Relationship:

Company Name: Position:

Contact No. Years Known:

Name: Relationship:

Company Name: Position:

Contact No. Years Known:

DECLARATION

I declare that all the above information is true and complete and I am liable to disciplinary action
conducted against me for falsifying or not declaring any of the above information required. I
understand that my employment is subjected to my passing the medical examination conducted by
the appointed Panel Doctor. False or inaccurate information given will render any subsequent
employment null and void.

Signature of Applicant Date


AUTHORIZATION FOR RELEASE OF INFORMATION FOR EMPLOYMENT
PURPOSES

Background Screening Disclosure

I hereby agree and authorize Xiamen University Malaysia XMUM


designated agents and representatives to conduct a comprehensive review/check on
my background for the purposes of my employment with XMUM, through a consumer
report and/or a background check report to be generated for employment, promotion,
reassignment or retention as an employee of XMUM. I understand that the scope of
the report/background check report may include, but is not limited to, the processing,
verification, storage and retention of information in the following areas: names and
dates of previous/current employment, work experience, wor
compensation/claims, criminal history records (from local, state, federal, international
and other law enforcement agencies records), wants and warrants records, motor
vehicle records, educational verification, license verification, business interest and
directorship, financial checks with Credit Reporting Agencies and Bank Negara
Malaysia Central Credit Reference Information System or CCRIS record, civil cases,
Personal Records

Authorization and Release

I, _______________________________, hereby consent and authorize the complete


and full release of the Personal Records or data pertaining to me which an individual,
company, firm, corporation, school, consumer or registered credit reporting agency,
governmental or public agency may have to XMUM, without any reservation. I hereby
release XMUM and its agents, officials, representatives, or assigned agencies,
including officers, employees, or related personnel both individually and collectively,
from any and all liability for damages of whatever kind, which may at any time, result
to me, my heirs, family or associates because of compliance with this authorization for
release form.
I confirm that all information provided by me in support of my application for
employment is accurate and complete in all aspects. I understand that
misrepresentation or omission will constitute sufficient ground for rejection or
subsequent termination of employment at any time if I am employed by XMUM. This
authorization and consent shall be valid in original, fax, or copy form and continue to
be valid until such time the consent is withdrawn by me in writing and communicated
to XMUM.

XMUM will maintain in strict confidence of the Personal Records and the following
information unless otherwise so required to be disclosed by laws, regulations and legal
proceedings and/or to any third party deemed so necessary or appropriate by XMUM
for the purposes related to my employment and background screening.

____________________Mobile Phone: ____________________

ID/Passport Number: __________________Date of Birth: _____________________

(This will not affect hiring decision)

Current Address:
___________________________________________________________________

___________________________________________________________________

________________________

Date:

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