EMPLOYMENT APPLICATION FORM

Passport Photo
affix here/
RNC GROUP Digital Image
RNC Holdings Sdn Bhd [435784-W] RNC Repair Specialist Sdn Bhd [1254630-
T]

RNC Technology (Sabah) Sdn Bhd [326829-A] RNC Integral Concrete Technology (M)
Sdn Bhd [436178-D]

RNC Technology (M) Sdn Bhd [252360-D] Others :

__________________________________________
HR Dept Use :

Job Application For Position :

SECTION 1 : PERSONAL INFORMATION NOTE: ALL IN

CAPITAL LETTER
Please provide photocopy of Identification Card/Passport and Working Permit
Full Name:

Date of Birth Gender

Place of Birth Race

Age Religion

Nationality License

NRIC/Passport No. Old NRIC No.

Marital Status No. of Children

EPF No. SOCSO No.

Income Tax No. CIMB Bank A/C :

CIDB No.

SECTION 2 : CONTACT DETAILS [Must be fill up]

Home Address Home No.

Correspondence Address Home No.

Mobile No.

Personal Email

Private & Confidential [HRER_V1] Employee

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SECTION 3 : EMERGENCY CONTACT [State at least 2 person]
Name Tel/Mobile No. Relations Address
hip

SECTION 4 : EDUCATIONAL QUALIFICATIONS

Please provide a photocopy of certificate(s)
Institutions Qualification From To CGPA/Grad
e

SECTION 5 : OTHER ACADEMIC OF PROFESSIONAL QUALIFICATIONS [including

training courses attended]
Institutions Course/Program taken From To Awards /
Grade

SECTION 6 : SCHOLARSHIP & AWARDS

Institutions / Provider Description From To Title Given

SECTION 7 : HOBBIES / LEISURE ACTIVITIES

Private & Confidential [HRER_V1] Employee 2
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SECTION 8 : SPOUSE DETAILS (COMPULSORY – IF APPLICABLE)
Spouse Full Name:

NRIC/Passport No. Date of Birth/Age:

Income Tax No. House No.

Type of tax. [Ps. Joint Mobile No.

Tick] Individual
Occupation / Office No.
Position
Employer Name

SECTION 9 : CHILDREN DETAILS

Name Age Occupation Employer /Educational To elect for
Institution Tax Relief
Yes / No

Yes / No

Yes / No

Yes / No

Yes / No

Yes / No

Yes / No

SECTION 10 : FAMILY BACKGROUNDS – Parents, Brothers, Sisters

Name Age Relationship Occupation/Employer

Private & Confidential [HRER_V1] Employee 3

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SECTION 11 : EMPLOYMENT HISTORY [State in chronological order. Please attached with
your updated resume].
Period Company Nature of Position & Last Reason of
Business Drawn Salary Leaving
From To

From To

From To

From To

SECTION 12 : REFERENCE DETAILSS

Name Job Title Employer Telephone No.

SECTION 13 : COMPUTER LITERACY [Proficiency : Advanced = 4; Poor : 1; please circle your

proficiency level]
Software Proficiency
Microsoft Office 1–2–3-4
Power Point 1–2–3-4
MS Project 1–2–3-4
AutoCad 1–2–3-4

Private & Confidential [HRER_V1] Employee 4

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Others : 1–2–3-4
Typing speed [w.p.m]

SECTION 14 : LANGUAGE [Please state : Fair, Good, Excellent]

Language Spoken Written Read
English
Bahasa Malaysia
Mandarin
Others : please specify

SECTION 15 : MEDICAL/HEALTH INFORMATION

Inquiry Status
Do you have any illness or injury? Serious Minor No
If yes, please indicate the detail.

Do you required for any Yes No

treatment?
If yes, please describe the detail.

Have you make claim on this

condition?
If yes, please describe the types &
date of claim.
For FEMALE ONLY : Declaration
of pregnancy Yes If Yes, _________months (age of
Are you pregnant? pregnancy)
No

SECTION 16 : NOMINEE (to be used during employment with RNC)

I ____________________________________________ I/C No ________________________________ hereby
named the individual below as my nominee if I die while still having an employment
with the Company.
Name I/C or Birth Certificates Relationship Percentage
given

Private & Confidential [HRER_V1] Employee 5

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 Total [ 100%]

SECTION 17 : OTHER INFORMATION

Checklist Yes No Please state /
other remark
Would you be willing to relocate? [ ] [ ]
Are you willing to travel? [ ] [ ]
Are able to work overtime? [ ] [ ]
What about working on [ ] [ ]
weekends?
Do you own any transport? [ ] [ ]
Do you know any of our employees [ ] [ ]
personally? If yes state the
name :
Period of notice of termination [ ] [ ]
required by your current employer 1 month 2 months
:
When would you be available for
new employment?
May we check with your [ ] [ ]
references-present and past
employer :

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Expected Salary : [ ] [ ] RM
Is it negotiable?

SECTION 18 : APPLICATION’S CERTIFICATION & DECLARATIONS

I certify that, to do the best of my knowledge and belief, the information given by myself to the
foregoing questions and the statements made by myself in this application are correct and
complete. I understand that falsifying personal information will render to immediate dismissal
without compensation or notice or whatsoever, if I am hired.

I hereby AUTHORIZE the Company (RNC) to communicate with any of my references and also
ALLOW you to check my CTOS record (if applicable). I also hereby release all employers, schools
and individuals from any damage whatsoever resulting from giving such information.

I also understand is my responsibility to inform HR Department the changes of address,

telephone no. and emergency contact and etc., during my employment period.

I enclose with [ ]Resume [ ] Photocopy of certificate(s) [ ] Photo

Signature __________________________________ Date

_________________________

OFFICE USE ONLY

RECOMMENDATIONS :
Hire Not Hire Other Action (please specify ) :
_________________________________

Date Joined : __________________________________ Reporting To :

____________________________________

Private & Confidential [HRER_V1] Employee 7

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Designation : __________________________________ Department :
_____________________________________

Basic Salary : __________________________________ Allowances :

______________________________________

Others : ______________________________________

Probation : 3 months 6 months

Recommend by : Approved by :

………………………….. …………………………..
Name : Name :
Date : Date :

Private & Confidential [HRER_V1] Employee 8

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