Strictly Private & Confidential

APPLICATION FOR EMPLOYMENT / PERMOHONAN PEKERJAAN

PHOTO
GAMBAR

DIRECTION ON USE / ARAHAN UNTUK MENGISI BORANG

1. Please read through the form carefully before completing it. 4. If after engagement it is found that a FALSE declaration has been made in the
Sila baca borang ini dengan teliti sebelum mengisi dengan form, the Company reserves the right to terminate my service with immediate
lengkap. effect.
Jika didapati maklumat-maklumat yang diberi tidak benar/palsu, pihak majikan
2. Completion of this form either be type or handwritten and
berhak menamatkan perkhidmatan saya dengan serta merta.
attached with 2 recent passport size photographs.
Jawapan anda boleh ditaip atau ditulis. Sertakan 2 keping 5. Privacy
gambar berukuran passport yang terbaru. UOA Hospitality Sdn. Bhd. (the Company) will abide by the Personal Data
Protection Act 2010 including any and all amendments and modifications
3. Copies of certificates/ testimonials must be attached to this
thereto. You hereby explicitly consent to UOA Hospitality Sdn. Bhd. (the
form. Originals to be brought during interview.
Company) processing your personal data and sensitive personal data which
Sertakan salinan-salinan sijil/testimonial anda bersama borang reasonably arise in/out of connection with your employment with UOA
ini, Sijil-sijil asal mestilah dibawa semasa temuduga. Hospitality Sdn. Bhd. (the Company). Details of UOA Hospitality Sdn. Bhd. (the
Company)’s personal data protection policies are contained in the Privacy
Notice which is available upon request.

I hereby declare that the information that I am submitting in this form is to the best of my knowledge and in every respect true and correct.
Saya mengaku bahawa segala maklumat yang diberikan dalam borang ini adalah yang betul dan benar sejauh mana di dalam pengetahuan saya.

27/2/2025
Date of Application Signature of Applicant
Tarikh Permohonan dibuat Tandatangan Pemohon

POSITION APPLIED FOR

JAWATAN YANG DIPOHON

1 2
Demi Chef

PERSONAL PARTICULARS
BUTIR-BUTIR PERIBADI
Full Name (as in NRIC) Sex :
Nama Penuh Jantina :
(seperti dalam kad pengenalan) Nur Syakireen Binti Azemi Female
Address :
Alamat :
No 17 Jalan Sg 9/2 Taman Sri Gombak,68100 Batu Caves, Selangor
Place of Birth : Date of Birth : Telephone No. : (Home/Rumah) :
Negeri dilahirkan : Tarikh Lahir : No. Telefon : (Office/Pejabat) : 011-28182876
Selangor 06 June 1999
Passport No. : Driver’s License : Citizenship :
A B C D E
Type : Class : Kewarganegaraan :
No. Passport : - No. Lesen Memandu : Malaysia
Jenis : Kelas : B2 & D
Race : Religion : NRIC No. :
Bangsa : Agama : No. Kad Pengenalan :
Melayu Islam 990606106164
EPF No. : Income Tax Ref : Socso No. :
No. K.W.S.P : Ruj. Cukai Pendapatan : No. Keselamatan Sosial :
- -
Height (cm): Weight (kg) : Physical Disabilities :
Tinggi (cm): Berat Badan (kg) : Kecacatan :
168 55 -
Marital Status :
Status Kahwin : Single Married Widowed Separated Divorced
Bujang / Berkahwin Balu Berpisah Bercerai
 EDUCATIONAL DETAILS
MAKLUMAT MENGENAI PELAJARAN

School / University / Highest Standard Passed / Certificate / Degree /

Professional Institute From To Professional Qualifications
Sekolah / Universiti / Dari Hingga Kelulusan tertinggi / Sijil / Ijazah /
Institut Kemahiran Kelulusan Ikhtisas

United international technology management college 2015 2016

Certificate in culinary and art

Computer Knowledge :
Pengetahuan Komputer :
Excellent

Other skills possess(es) :

Kemahiran-kemahiran lain yang dimiliki :

PREVIOUS EMPLOYMENT including temporary work (Start with your present job)
PEKERJAAN DAHULU Termasuk pekerjaan sementara (Mula dengan pekerjaan sekarang diikuti dengan yang sebelumnya)
From To Name and Address of Employer Position Held Salary (per month) Reason for Leaving
Dari Hingga Nama dan Alamat Majikan Jawatan yang di pegang Gaji (sebulan) Sebab-sebab berhenti

January 2023 Dorsett KL Comis 1 2400 Find new environment

July 2022

January 2023 August 2023 Paris baguette Senior chef 2500

August 2023 Present Paul bakery and restaurant Demi chef 2600

BRIEF DESCRIPTION OF PRESENT DUTIES

NYATAKAN TUGAS ANDA SEKARANG

- Work planing
- Do MEP and things to do that need to be done
- arrange storage
- handling al carte
- do inventory

LANGUAGE PROFICIENCY – Mother Tongue or Family Dialect

KECEKAPAN BAHASA – Bahasa Ibunda / Loghat
SPOKEN WRITTEN UNDERSTANDING
Languages Dialects PERTUTURAN PENULISAN KEFAHAMAN
Bahasa / Loghat Well Fair Poor Well Fair Poor Well Fair Poor
Baik Sederhana Lemah Baik Sederhana Lemah Baik Sederhana Lemah
Bahasa malaysia / / /

English / / /

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 PARTICULARS OF IMMEDIATE FAMILY (spouse, children, parents, brothers and sisters)
BUTIR-BUTIR KELUARGA (suami/isteri, anak, ibu-bapa, abang, kakak dan adik)

Name Relationship Age Occupation Place of Occupation

Nama Tali Perhubungan Umur Pekerjaan Tempat Bekerja

Husband Freelance
Jusney bin mokhtar
26

RELATIVES CURRENTLY IN EMPLOYMENT IN THIS COMPANY

SAUDARA-MARA YANG BEKERJA DI SYARIKAT INI
Name Position Held Relationship
Nama Jawatan yang dipegang Tali Perhubungan

CHARACTER REFEREES (Name of relatives should not be given)

RUJUKAN PERIBADI (yang tiada tali perhubungan)
Years Known
Name Company Name Office Tel. No. Current Profession
Berapa tahun
Nama Nama Syarikat No. Tel. Pejabat Pekerjaan Sekarang
mengenali pemohon

Present Hobbies/ Interests/ Sports :

Hobi Sekarang/ Kegemaran/ Sukan :
Are you suffering from any major illness such as heart disease, diabetes, cancer, etc?
Adakah anda mempunyai sebarang masalah kesihatan seperti masalah jantung, kencing manis, kanser dan lain-lain?
If so, what is the medical condition? Yes No
Sekiranya “Ya”, nyatakan masalah kesihatan tersebut? Ya / Tidak

Salary Expected : Termination Notice for present job:

2700
Gaji yang diharapkan : Notis berhenti kerja untuk pekerjaan sekarang: 1 month
Have you ever been discharged from employment for misconduct? Yes No
Pernahkah anda dibuang kerja kerana kesalahan tingkah laku? Ya
/ Tidak
Have you ever been arrested by the police? Yes/ Ya Have you ever been convicted for any crime? Yes/ Ya
Pernahkan anda ditangkap oleh pihak polis? Pernahkah anda dihukum bersabit kesalahan jenayah?
/ No / Tidak / No / Tidak
If “Yes” for both questions, please give details :
Sekiranya “Ya” untuk kedua-dua soalan di atas, sila berikan keterangan lanjut :

Name of person to notify in case of accident : Jusney Relationship :

Nama orang yang perlu diberitahu sekiranya berlaku kemalangan : Tali Persaudaraan : Husband

Address : Tel. No. / No. Tel : 01165071077

Alamat : No 17 Jalan Sg 9/2 Taman Sri Gombak 68100 Batu Caves selangor

Your reason(s) for joining UOA Hospitality Sdn. Bhd. :

Nyatakan sebab-sebab anda ingin berkhidmat dengan UOA Hospitality Sdn. Bhd. :

Interested to learn new things and new environment

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 FOR OFFICIAL USE ONLY / UNTUK KEGUNAAN PEJABAT SAHAJA
Remarks/ Catitan

Referred by
Name :
Associate ID :
Department :

Date : Position applied for :

Tarikh : Jawatan yang dipohon :

Interviewer’s Assessment : Interviewer 1 Interviewer 2 Interviewer 3

Penilaian Penemuduga : Penemuduga 1 Penemuduga 2 Penemuduga 3
REMARKS REMARKS REMARKS
A B C A B C A B C
CATITAN CATITAN CATITAN
EDUCATION
PELAJARAN
EXPERIENCE
PENGALAMAN
ATTITUDE
SIKAP
LANGUAGE
BAHASA
TECHNICAL KNOWLEDGE OF THE JOB
PENGETAHUAN TEKNIKAL MENGENAI
PEKERJAAN
COMMUNICATION ABILITY VERBAL/WRITTEN
KEBOLEHAN BERHUBUNG LISAN/ PENULISAN
OTHER QUALITIES
LAIN-LAIN KEBOLEHAN
Personality
Personaliti
General Appearance
Rupadiri
Intelligence
Kecerdasan
Confidence
Keyakinan
General Knowledge
Pengetahuan Am
Signature Signature Signature
Tandatangan Tandatangan Tandatangan
CODE : x A. Above Average B. Average C. Below Average
KOD : A. Baik B. Sederhana C. Kurang Baik

Remarks Accepted Not Accepted KIV

Catitan Diterima Tidak Diterima Simpan sebagai rujukan
Position Offered : Department :
Jawatan yang ditawarkan : Jabatan :

Date / Tarikh : Department Head Signature / Tandatangan Ketua Jabatan :

FOR HUMAN RESOURCES USE ONLY / UNTUK KEGUNAAN JABATAN SUMBER MANUSIA SAHAJA
Salary on Probation : Salary on Confrmation : Date of Commencement :
Gaji semasa percubaan : Gaji setelah disahkan : Tarikh mula berkhidmat :
Instruction to Human Resources Personnel / Arahan kepada Kakitangan Jabatan Sumber Manusia

Approved. Please process for employment. Not Approved. Please inform Head of Department concerned.
Diluluskan. Sila uruskan pekerjaan Tidak diluluskan, Sila beritahu kepada Ketua Jabatan berkenaan.

Head of Human Resources Department / General Manager

Ketua Jabatan Sumber Manusia/ Pengurus Besar

Important Notice / Notis Penting

Interviewers are not allowed to discuss salary and benefits with the candidates, unless prior discussion has been made with Head of Human Resources
Department. Otherwise, any salary and benefits discussion with candidates are strictly by the Human Resources Authorized Personnel only.

Penemuduga tidak dibenarkan berbincang perihal gaji dan faedah-faedah kerja kepada calon yang ditemuduga kecuali perbincangan awal berkenaan gaji
telah di adakan dengan Ketua Jabatan Sumber Manusia. Sebarang perbincangan gaji dan faedah-faedah kerja hanya akan dilakukan oleh pihak Sumber
Manusia.

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