52-HR80-0014 Revision

APPLICATION FOR EMPLOYMENT B

POSITION APPLIED FOR:

PERSONAL DATA

NAME IN BLOCK:

E-MAIL ADDRES:

PERMANENT ADDRESS: CORRESPONDENCE ADDRESS TELEPHONE NUMBER:

HOME :
OFFICE :
MOBILE :
POSTCODE: POSTCODE:
NATIONAL ID: PLACE OF BIRTH: MARITAL STATUS:
e.g. married with (x number of children)
IDENTITY CARD NO:
Driving license ID: DATE OF BIRTH: CITIZENSHIP:

TAX REGISTER NUMBER: BPJS KETENAGAKERJAAN No: BPJS KESEHATAN No:

RELIGION: GENDER: MALE FEMALE

LANGUAGE SPOKEN LANGUAGE WRITTEN

OTHERS :__ OTHERS :

________
BAHASA ENGLISH ______ BAHASA ENGLISH

ANY STATUTORY OF VIOLATION OR CRIMINAL CONVICTION BEFORE?:

If yes, please state Yes No

___________________________________________________________________________________________________________

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APPLICATION FOR EMPLOYMENT B

ACADEMIC QUALIFICATIONS

Education level from to School/College/University Major/ Specialization Grade achieved

PROFESSIONAL QUALIFICATIONS

Qualification From to duration Institute/Venue

TRAINING ATTENDED

From To Duration Courses Institute/Venue

PROFESSIONAL CLUB MEMBERSHIP

From To Duration Club/Activities Institute/Venue

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 52-HR80-0014 Revision

APPLICATION FOR EMPLOYMENT B

EMPLOYMENT HISTORY

Date
Name of Company Position Held Brief job description Last drawn salary Reason for leaving
From to

Please specify any promotion or upgrading within A company

PERSONAL REFERENCES

(Do not state any family members or relatives)

Name Relationship Occupation Name of Company Contact details (phone, email, etc) Years known

Note: the company may contact your previous/current employer and personal references stated Yes No
above for cross check. Do you have any objection?

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APPLICATION FOR EMPLOYMENT B

GENERAL INFORMATION
1) Person to contact during emergency

Name Relationship Address Telephone Number:

2) Physique

a) Any physical disabilities? Yes If yes, please state ________________) No

b) Major Illness with approximate date ____________________

3) Have you been referred to someone you know as an existing Jabil employee
to apply to this position?
Yes Please give details below No

a) Name
Relationship Position Department

Mother / Father / Spouses / Brother / Sister / Uncle / Aunty / Sibling / Other ..

b) Name Relationship Position Department Years Known

Friend
Is he/she personally know you

Yes No

4) Are you able to work on shift ? Yes No

5) Have you ever been worked for Jabil before? If YES, please provide details Yes No

Positions Years Supervisors:

6) Have you ever been dismissed from previous employment? If YES, please provide details
Yes No
______________________________________________________________________

7) Have you ever been declared bankrupt, suspended payment or have

compunded with your creditors? Yes No

If YES, please provide details________________________________________

8) Have you ever been convicted for criminal charge? If YES, please provide details
Yes No

9) Soonest possible date to join Jabil Circuit Indonesia, if successfull:

10) Expected salary : 11) Next salary review in current employment

I certify that all information above furnished by me is true and complete. If I am successfully employed by Jabil
Circuit Indonesia, Bandung, I understand that any information furnished above which is not true, distorted or
misleading would be sufficient ground for discharge or immediate termination of my employment engagement
with the Company.
_____________________ ________________
Signature of ApplicantDate

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APPLICATION FOR EMPLOYMENT
Name (In Block Letters) :
Office
Home
H/Phone
Postcode :
Postcode :
Telephone Numbers
POSITION APPLIED FOR:
Permanent Address :
Correspondence Address :
PERSONAL PARTICULARS
SOCSO No :
Age :
English
Malay
Tamil
Old :
Mandarin
Male
Others :
Tamil
D.O.B (mm/dd/yy) :
State Of Birth :
Languages Written :
English
Malay
Gender :
New :
Languages Spoken :
E-mail Address :
__________
Form #: 07-HR10-GEN-001-01D
(Years)
From
2
Institute/Venue
Position Held
PROFESSIONAL CLUB MEMBERSHIP & ACTIVITIES INVOLVED
To
Duration
(mm/yy)
Club/Activities
(mm/yy)
School/College/University
Major/ Specialization
(Years)
From
To
Duration
Courses
Institute/Venue
(mm/yy)
Training Attended
Education Level
From
To
(mm/yy)
(mm/yy)
Grade Achieved (eg. CGPA/Class)
SRP/PMR
SPM/SPVM/O-LEVEL
Duration
MASTERS DEGREE
To
From
Professional Qualifications
(mm/yy)
ACADEMIC QUALIFICATIONS
CERTIFICATE
DIPLOMA
BACHELOR DEGREE
(mm/yy)
(Years)
STPM/A-LEVEL
(mm/yy)
PhD
Duration (Years)
Qualification