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Application For Employment

Post applied for :
Tentative date to
Salary Expected : Start employment :

I PERSONAL DETAILS
Full Name Place of birth
*Mr/Mrs

Aliases (if any) Date of birth

Address Citizenship

ID No.

NPWP No.

Religion

Office : Home: Dialect Group

Pager : Handphone : Passport No. (if non-Citizen)

Marital Status : Date/Place of Issue

*Single/Married/Divorced/Widowed/Separated

Possess Driving License Yes No Email:

II FAMILY PARTICULARS (Please include all family members, including married ones)
Name Relationship Age Occupation Place of Occupation

If in case of emergency

Person to contact Contact No 1

Relationship Contact No 2

Address

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 III EDUCATION (Please attach all relevant certificates, if requested)
NAME OF SCHOOL From To Highest Standard Passed

Primary

Secondary

Pre-University

University

Polytechnic

Vocational

Professional Institute

Others

Part-Time Courses
Studied Now

Part-Time Courses Which

You Intend To Study

Merit Awards Received Year:

IV EMPLOYMENT HISTORY (Please attach all relevant testimonials)

NAME OF COMPANY
(Begin with Present Employer) Position Held From To Basic Salary Allowance

Job Responsibilities

Job Responsibilities

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V ACTIVITIES
1. Of what Associations/Societies were/are you a member?

In School/Institute/Elsewhere Position Held Approximate Dates

2. Present hobbies / interest /

sports :

VI PERSONAL REFERENCE
Name Contact No. Profession Years Known to you

VII GENERAL
1. Languages/Dialects written/spoken?

2. Are you suffering from any illness/disease?

3. Are you on any medication?

4. Physical disabilities or handicaps suffered:

5. Have you ever been convicted of a criminal Yes No

offence?
If Yes, give details

6. Have you been a member of any Employee Yes No

Union?
If Yes, state rank

7. Have you any relatives/friends you know in Yes No

our employment?
If Yes, give details

VIII How Did You Get To Know About This Vacancy?

Advertisement Employee Referral Others (Please Specify)

Campus Recruitment Agency Referral

Friends Vendor Referral

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I declare that to the best of my knowledge, the particulars provided are true and I hereby give my consent to the company to check my
employment records with my previous employers. I am aware that any false or misleading statements made by me will be cause for
dismissal if employed.

I also authorize the Company to submit the said information to any person, firm, corporation, body, bureau, department, police or
government authority for the purpose of any investigation and verification of any information. I also indemnify the Company from all
liabilities, demands, claims, suits proceedings, costs and expenses of any nature in connection with the above matter.

Signature of Applicant Date