TOP GLOVE SDN BHD (Company No.

220483)
GOOD HEALTH, SAFETY FIRST & BE HONEST
Affix Photo
A member of Top Glove Corporation Bhd, Public Listed Company on Bursa Malaysia & Singapore Exchange. Here
Head Office : Lot 4969, Jalan Teratai, Batu 6, Off Jalan Meru, 41050 Klang, Selangor D. E., Malaysia
(Factory 9) Tel: 603-3392 1992 / 1905 Fax: 603-3392 8410 / 1291
Email : sales@topglove.com.my Website: www. topglove.com.my

EMPLOYMENT APPLICATION FORM

FOR OFFICE USE ONLY
POSITION APPLIED:

1. NAME AND ADDRESS Source *: _________________________

a) Full Name : Badge No.:

b) Other Name: c) Name in Chinese : Factory :

d) Address: e) Home Tel. No. :
f) Office Tel. No. :
g) Email Address: h) Handphone No. :

2. PERSONAL DETAILS

a) Gender: b) Age: c) Date of Birth:

d) Place of Birth: e) Nationality :

f) Race: g) Religion :
h) NRIC No.: (New) i) EPF No. :
(Old)

j) Working Permit (If any): k) Socso No. :

l) Marital Status: m) Driving License D B2 Others:

n) Income Tax No. : o) Height: p) Weight:

q) Have you been charged or convicted for any criminal, if yes, please state the case

3. FAMILY DETAILS

a) Name of Spouse: Occupation :

b) No. of Children : Son: Daughter :

c) i. No. of Children Currently in School :

ii. No. of Children Currently Working :

d) Name of Father : Occupation :

e) Name of Mother: Occupation :

f) Father’s Address:

g) Contact Person (In Case of Emergency) : Handphone No. :

4. LANGUAGE ABILITY
Speaking Writing
Language
Moderate Good Excellent Moderate Good Excellent

1.

2.

3.

4.

*State how you know about this vacancy.

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5. HEALTH

a) Health Status : b) Any Disability :

c) Do you smoke (including vape and/or any other form)?

Previous Present

Yes No Yes No

d) If previously you were a smoker when did you stop this habit?

e) Are you currently pregnant? Yes No

6. EDUCATION DETAILS

Highest Certification Grade /

Education Details Name From To Majoring
Obtained CGPA
1.

School 2.
3.
1.
College or
2.
University
3.

Additional 1.
Professional 2.
Qualification
3.
(Attended or
currently pursuing) 4.
1.
Membership of 2.
Professional Body
3.

7. STATE ANY AWARDS OR ACHIEVEMENTS RECEIVED AT SCHOOL, COLLEGE, ETC.

8. ACTIVITIES
a) Games/Sports/Hobbies:
In School In College/University Current Activities

b) State the post you held at School/College/University

c) State if you are a Member in Society, Club and Post Held

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9. PREVIOUS EMPLOYMENT (Beginning with the most recent)

Employer / City Designation Date Start / End Salary Reason for Leaving
a)
b)
c)
d)
e)
f)
g)

10. PRESENT EMPLOYMENT

a) Employer:

b) Address:

c) Date Joined:

d) Designation:

e) Starting Salary:

f) Present Salary:

g) Yearly Bonus:

h) Fringe Benefits:

i) Reason(s) for leaving:

j) Expected Salary:

k) Notice Period / Earliest Joining Date:

11. IN WHAT AREAS THAT YOU THINK YOU CAN CONTRIBUTE MOST TO TOP GLOVE AND WHY
YOU SHALL BE OFFERED THIS JOB?

REFERENCE (IN RELATION TO WORK PERFORMANCE - PREFERABLY EX-SUPERIOR)

Name : Name :
Occupation : Occupation :
Address : Address :

Tel. No. : Tel. No. :

Relationship : Relationship :

Can we contact the listed referee for reference purposes? Yes No

I hereby declare that I am above 18 years old and all information provided is valid and true. I also consent and authorise all my
personal data stated in this form, cover letter, resume / curriculum vitae and other related documents to be processed for the
purpose of recruitment, in accordance with the Personal Data Protection Act 2010.
Saya dengan ini mengakui bahawa saya telah mencapai umur 18 tahun & keatas dan mengesahkan bahawa segala maklumat yang
diberikan diatas adalah benar. Saya juga membenarkan semua data peribadi saya yang dinyatakan didalam borang permohonan ini
bersama surat lampiran dan resume/ kurikulum vitae untuk diproses bagi tujuan pengambilan kerja adalah mengikut Akta
Perlindungan Data Peribadi 2010.

Name : Signature : Date :

Page 3 of 3 Rev.3 (HR/F01)