KOPERASI PELABURAN KAKITANGAN BANK

PHOTO /
MUAMALAT MALAYSIA BERHAD (KOPUTRA) GAMBAR

Employment Application / Borang Permohonan Pekerjaan

APPLICANT INFORMATION / MAKLUMAT PEMOHON

Name /Nama Date/ Tarikh

Address / Alamat

Date of Birth/
I/C No
Tarikh Lahir
Phone / No Tel EPF /SOCSO

Expected Salary / Date Available /

Gaji Diminta Tarikh
Position Applied /
Jawatan yang

EDUCATION / PENDIDIKAN
High School/Sekolah Address

Did you YES NO Level /

From / Dari tahun To
graduate? Peringkat

College/Kolej Address

Did you YES NO Level/

From To
graduate? Peringkat

University/Universiti Address

Did you YES NO Level /

From To
graduate? Peringkat
Ad
Other/Institusi Lain
dre
ss
Did you YES NO Level /
From To
graduate? Peringkat

REFERENCES/ RUJUKAN
Please list two professional references. / sila senaraikan dua rujukan
Relationship
Full Name / Nama
/ Hubungan
Phone /
Company / Syarikat
No.Tel
Address / Alamat

Relationship
Full Name / Nama
/ Hubungan
Phone /
Company / Syarikat
No .Tel
Address / Alamat
PREVIOUS EMPLOYMENT / PEKERJAAN SEBELUM
Company /
Phone / No.Tel
Syarikat
Supervisor /
Address/ Alamat
Penyelia
Job Title / Starting Salary / Ending Salary
Jawatan Gaji Permualaan / Gaji Akhir
Responsibilities /
Tanggungjawab
Reason for Leaving /
From To
Sebab Berhenti
May we contact your previous supervisor for a reference?
YES NO
/ Boleh kami menghubungi majikan lama untuk rujukan?

Company /
Phone / No.Tel
Syarikat
Supervisor /
Address/ Alamat
Penyelia
Job Title / Starting Salary / Job Title /
Jawatan Gaji Permualaan Jawatan
Responsibilities
/Tanggungjawab

From To From

May we contact your previous supervisor for a reference?

YES NO
/ Boleh kami menghubungi majikan lama untuk rujukan?

Company /
Phone / No.Tel
Syarikat
Supervisor /
Address/ Alamat
Penyelia
Job Title / Starting Salary / Job Title /
Jawatan Gaji Permualaan Jawatan
Responsibilities /
Tanggungjawab

From To From

May we contact your previous supervisor for a reference?

YES NO
/ Boleh kami menghubungi majikan lama untuk rujukan?

FAMILY INFORMATION / MAKLUMAT KELUARGA

Spouse / Pasangan
Name / Nama Occupation / Pekerjaan Tel. No Employer Name / Nama Majikan

Sibling / Adik beradik

Name / Nama Occupation / Pekerjaan Tel. No Employer Name / Nama Majikan

1)

2)

3)

4)

5)
SUPPLEMENTARY DETAIL / MAKLUMAT TAMBAHAN
YES / YA NO / TIDAK

Have you any problem for travelling? / Adakah anda ada masalah dari segi perjalanan?

Do you own a motorcycle/car? / Adakah anda mempunyai kenderaan ?

Do you hold a valid driving licence? / Adakah anda mempunyai lessen memandu?
Do you have any relatives/friend working in KOPUTRA? / Adakah anda mempunyai kenalan di
KOPUTRA?

Name / Nama :
Department / Jabatan :
Relationship / Hubungan :
Notice period to present Employer? / Tempoh menamatkan notis majikan sekarang?

DECLARATION
YES / YA NO / TIDAK

I do not have any major disease / illness

I do not have any physical disablement

I do not have any serious medical condition

I have not been arrested before

I have not been in prison for any criminal act

I have not have any criminal record/charges

I am not currently pregnant (for female candidate only)

DISCLAIMER AND SIGNATURE / PENAFIAN DAN TANDATANGAN SUPPLEMENTARY DETAIL / MAKLUMAT

TAMBAHAN
1) I hereby authorize Koperasi Pelaburan Kakitangan Bank Muamalat Malaysia Berhad (KOPUTRA) to conduct credit checks with Tip-
Off System (CTOS) and/or any other credit reference agencies or any background/reference check from my current/former
employers for a period up to seven (7) years from the date application.
2) I hereby declare that I have made full and true disclosure of all material fact and information to the best my knowledge and I
have not concealed or omitted any material fact or information and I fully understand that if any declaration, material fact or
information provided above are found incorrect, incomplete or untrue, KOPUTRA reserves its absolute right to terminate my
employment without notice or compensation.
3) I hereby consent KOPUTRA to share this application within subsidiary/Associate Companies should there any position available
and suitable to me.

Signature / Date /
Tandatangan Tarikh