EMPLOYMENT APPLICATION FORM
POSITION APPLIED : SERVICE ENGINEER
PASSPORT
SOURCE : Recruitment Company/ Job Street / Website / Our Staff Recommendation SIZE
(Name of Staff: ________________________________________________)
PHOTO
(Others:_____________________________________________________)
PERSONAL DATA
FULL NAME (as in NRIC) AMMIRRUL IKHMAL BIN AHMAD DAUD NRIC NUMBER 930110-10-6027
NO 105, JLN ANDALAS
Block B-9-19, Baiduri Court
1, TAMAN ANDLAS Apartment , jalan BP 14, Bandar
PERMANENT ADDRESS 71700, MANTIN,
CORRESPONDENCE ADDRESS Bukit Puchong 2, 47120
NEGERI SEMBILAN Puchong, selangor
TELEPHONE NO. (HOME) MOBILE PHONE NO. 017-6855308
DATE OF BIRTH 10/01/1993 GENDER MALE
PLACE OF BIRTH HOSPITAL BANTING NATIONALITY
SELANGOR
RACE RELIGION
MARITAL STATUS NUMBER OF CHILDREN
EPF NO INCOME TAX FILE NO.
BLOOD TYPE
FAMILY INFORMATION (PARENT, SIBLING, SPOUSE, CHILDREN)
FULL NAME (as in NRIC/Passport) RELATIONSHIP AGE OCCUPATION PLACE OF WORK
EMERGENCY CONTACT
NAME RELATIONSHIP HOME TELEPHONE NO. MOBILE PHONE NO.
Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997
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EMPLOYMENT HISTORY
DATE OF LAST DRAWN
CURRENT / PREVIOUS EMPLOYER DATE JOINED STARTING POSITION LAST POSITION REASON FOR LEAVING
RESIGNATION SALARY
EXPECTED SALARY DATE AVAILABLE
EDUCATION BACKGROUND
YEAR
SCHOOL / COLLEGE / UNIVERSITY HIGHEST QUALIFICATION
FROM TO
LANGUAGE PROFICIENCY & SKILLS
WRITTEN SPOKEN
LANGUAGE PROFICIENCY &
COMPUTER LITERACY
SKILLS
GOOD AVG POOR GOOD AVG POOR
ENGLISH
GOOD
MALAY
AVERAGE
CHINESE
POOR
OTHERS
Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997
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REFERENCES (Please do not include family members, friends or relatives)
NAME RELATIONSHIP CURRENT POSITION CURRENT COMPANY CONTACT NO.
OTHER INFORMATION
Do you suffer any physical defects or have you recovered from serious illness?
YES NO
If yes, please explain __________________________________________
Have you ever been convicted in court of law?
YES NO
If yes, please explain __________________________________________
Have you ever been discharged or suspended from service of employment?
YES NO
If yes, please explain __________________________________________
Are you currently pregnant or planning a pregnancy in the coming 6 months period? YES NO
Are you willing to work overtime, shift hours, during weekend and Public Holiday? YES NO
Are you willing to be transferred to other country or Department? YES NO
Any of your family or relative working with our company?
YES NO
Is yes, please state the name of the employee:__________________________________
I, hereby agreed and authorized the Company to direct bank in my monthly salary into my bank account. YES NO
Can we contact your previous employer for a reference check?
YES NO
If no, please state your reason ____________________________________________
Do you have any type of driving license?
YES NO
Please select: Car / Motor / Special Car License
DECLARATION
I declare that all information given by me in this application for employment is true and correct to the best of my knowledge. I understand that any
misrepresentation or omission of facts will be sufficient cause for cancellation of consideration for employment or dismissal from the Company's
service of employment.
Signature : Date :
Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997
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FOR OFFICE USE
RATING
PERSONAL ATTRIBUTES 1 2 3 4 5 POINTS REMARKS
POOR FAIR AVG GOOD EXC
APPEARANCE
PERSONALITY
ACADEMIC QUALIFICATION
COMMUNICATION ABILITY
WORKING EXPERIENCE
SKILLS ACQUIRED
TOTAL
RECOMMEND FOR 2ND INTERVIEW ACCEPTED KIV REJECTED
REMARKS :
INTERVIEWER NAME : DATE :
FOR MANAGEMENT USE
EMPLOYMENT PACKAGE DETAILS CHECKLIST (FOR HR USE)
COMMENCEMENT DATE : ________________________ 1. I/C PHOTOSTATE COPY
POSITION : ________________________ 2. PASSPORT SIZE PHOTO
DEPARTMENT : ________________________ 3. RESUME/ EDUCATIONAL CERT DOCUMENT
BANK ACCOUNT NO. : ________________________ 4. BANK A/C PHOTOSTATED
BASIC SALARY : ________________________ 5. LATEST MONTH SALARY SLIP COPY
OTHERS (1) : ________________________ 6. DRIVING LICENSE COPY
OTHERS (2) : ________________________ 7. UNIFORM ARRANGEMENT
TOTAL : ________________________
Interviewed By: Verified By: Reviewed By: Final Approved By:
Interviewer Head of Department HR Department
Name : Name : Name : Name :
Date : Date : Date : Date :
Unit 8-1, Jalan PJU 8/5E, Damansara Perdana, 47820 Petaling Jaya, Selangor Darul Ehsan, Malaysia. Tel: 603-77298994 Fax: 603-77298997
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