UNION CHAIN GROUP SDN BHD

EMPLOYMENT APPLICATION FORM

POSITION APPLIED :

PASSPORT
SOURCE : Recruitment Advertisements / Job Fair / Online / Website / Friend Recommendation SIZE
(Name of friend: ________________________________________________) PHOTO
: Newspaper: The Star / 星洲日报 / Harian Metro / 中国报 / 光华日报 / 光明日报

(Others: ______________________________________________________)

PERSONAL DATA

FULL NAME (as in NRIC) NRIC NUMBER

PERMANENT ADDRESS CORRESPONDENCE ADDRESS

TELEPHONE NO. (HOME) MOBILE PHONE NO.

DATE OF BIRTH GENDER

PLACE OF BIRTH MARITAL STATUS

NATIONALITY EPF NO.

RACE AND RELIGION INCOME TAX FILE NO.

WORKING SPOUSE NO. OF CHILDREN ______ boy(s) ______ girl(s)

FAMILY INFORMATION (PARENT, SIBLING, SPOUSE, CHILDREN)

NAME RELATIONSHIP AGE OCCUPATION PLACE OF WORK

EMERGENCY CONTACT

NAME RELATIONSHIP HOUSE TELEPHONE NO. MOBILE PHONE NO.

EMPLOYMENT QUESTIONNAIRE

1. Can we contact your previous employer? YES / NO

If no, please state your reason. Thank you.

 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
 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 a member of any Union or association?

YES NO
If yes, please state ____________________________________________

Are you willing to work overtime, shift hours, during weekend and Public Holiday? YES NO

Are you willing to be transferred to other Outlet or Department? YES NO

Have you worked in any of our group of companies before?

YES NO
If yes, please state ___________________________________________
Have you applied for any position in our group of companies before?
YES NO
If yes, the position applied for was:________________________________
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

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 :

By signing this application form, you consent to the use and/or processing of the personal data (including the sensitive personal data) provided herein by us, Rhombus Group of
Companies (“Company”) in accordance with the Privacy and Personal Data Protection Notice issued by the Company and agree to be bound by the same. The Notice will be
available upon request.

Signature : Date :

HOSTEL & UNIFORM REQUISITION ACKNOWLEDGEMENT

UNIFORM (CIRCLE WHERE APPLICABLE) OTHERS HOSTEL

TYPE : MANAGEMENT / SERVICE / KITCHEN APRON : REQUEST : YES / NO

SIZE : XL / L / M / S CAP : LOCATION :
QUANTITY : NAME TAG : DEPOSIT :
DEPOSIT : SAFETY BOOT :

I, ________________________________ , I/C ________________________ hereby agreed to deduct RM_________ from my first month salary as for the Uniform (& Others) and
Hostel deposit. I am agreeable that this deposit will only be refundable to me upon my resignation and with the conditions of returning the uniform in good condition to the Company.

Signature : Date :
 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 / OUTLET : ________________________ 3. RESUME/ EDUCATIONAL CERT DOCUMENT

BANK ACCOUNT NO. : ________________________ 4. BANK A/C PHOTOSTATED

BASIC SALARY : ________________________ 5. LATEST MONTH SALARY SLIP COPY

TRAVELLING ALLOWANCE : ________________________ 6. TYPHOID INJECTION COPY

HANDPHONE ALLOWANCE : ________________________ 7. DRIVING LICENSE COPY

ATTENDANCE ALLOWANCE ________________________ 8. UNIFORM ARRANGEMENT

MEAL ALLOWANCE : ________________________ 9. INTERVIEW CHECKLIST

OTHERS : ________________________ 10. CASH HANDLING POLICY

TOTAL : ________________________ 11. TRAINING AGREEMENT

REFERRING EMPLOYEE DETAIL EMPLOYMENT REFERENCE CHECK

YES NO
NAME (As per I/C) : _____________________________________

I/C NO. : _____________________________________ REMARKS : ____________________________________________

OUTLET : _____________________________________ ____________________________________________

RELATIONSHIP : _____________________________________ ____________________________________________

Interviewed By: Verified By: Reviewed By: Final Approved By:

Interviewer Head of Department HR Department

Name : Name : Name : Name :

Date : Date : Date : Date :