Employment Application Form

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2607 Jalan Perusahaan, Kawasan Perindustrian Prai,

13600 Prai, Penang.


Passport
Photo
APPLICATION FOR EMPLOYMENT
Personal Information Application Date_______________
Wan Atikah Binti Wan Azalan
Full name: _____________________________________________________________________
Skycube Residence, Lilitan Sg Ara, Bayan Lepas, Penang
Present Address: ____________________________________________________________________________
Skycube Residence, Lilitan Sg Ara, Bayan Lepas, Penang
Permanent Address: __________________________________________________________________________

Residence Telephone: ________________ Email Address : __________________Mobile


wanatikah@rocketmail.com 0124996937
Phone :_____________

Referred by :________________________________________________________________________________

___________________________________________________________________________________________
Employment Desired
Quality Engineer RM8800
Position :_________________________________________ __ Expected Salary :___________________
___ Full- Time ___ Part- time (If part-time, note the hours you can work)_________________________

Date you can Join:_____________________________________________________________________________

NO No If yes, When and where?_____________________


Have you ever been employed by Molex? ____ Yes ____

Have you ever interviewed with Molex? ____ Yes ____


NO No If yes, When and where?_____________________

Education Name of Institution Graduated Graduated Course Of Study / Degree


Yes No
High School

College/ University University of Auckland 2018-2019 MASTER OF ENERGY


YES

College/ University B. Hons. of Engineering Mineral


Universiti Sains Malaysia 2010-2014 YES
Resources Engineering

Other Training/ Educ.

YES
Are you 18 years or older? _____ Yes ____ No

Do you have any relatives who are currently employed at Molex? Relatives include parents, spouse, children, sibling,
NO
grandparents, aunts, uncle, cousin, in-laws, domestic partners or significant others. _____ Yes_____ No

If yes, state name and relationship_______________________________________________________________

HRF-G015 Rev D (ARN# May014/12) Page 1


NO
Are you employed now? ____ Yes ____ No YES Yes ____ No
If so, may we contact your present employer? ____
MSS, COPMANY DONWSIZING
Dates and reasons for lapses in employment:________________________________________________________

Molex Malaysia is an equal opportunity employer and does not discriminate in hiring or employment based on race, color,
religion, sex, national origin, ancestry, age, gender identify, citizenship status, sexual orientation, marital status, parental/
familial status, pregnancy, military discharge, genetic information, mental or physical handicap or disability, veteran status or
any other basis prohibited by state or local law. Molex Malaysia will not refuse to hire a disabled applicant who can perform
the essential functions of the job with reasonable accommodation. No question on this form is intended to secure information
to be used for such discrimination.

I certify that all my statements on the above applications and resume (if any) are accurate and complete. I understand that
that my employment will be contingent upon the accuracy of such information and that any misstatements, omissions or false
statements in this application will be sufficient cause for disqualification or immediate dismissal even if uncovered after
commencement of employment. I hereby grant Molex Malaysia permission to investigate all of the statements contained in
this application for the purpose of verification, and I agree to release Molex Malaysia and any parties the contact from any
liability arising from such investigation. I understand that my present employer will not be contacted unless my consent has
been obtained or I have accepted an offer of employment with Molex Malaysia, which would be contingent on that contact.

I have read the above paragraph and accept the same as a condition of my employment with Molex Malaysia.
25/10/2023
Signed: ______________________________________________________ Date: __________________________

Please provide us with 3 professional references that we may contact in an effort to proceed in our application
process. Please be advised that all offers of employment are contingent upon satisfactory background and
reference checks.

Name Title Telephone Number Relationship


1. AI SEE LOO QUALITY DIRECTOR 0124974832 PREVIOUS SUPERIOR

2. JONAS BAUTISTA QUALITY MANAGER 0166343079 PREVIOUS SUPERIOR

3. SITI NADIA SENIOR INVENTORY ANALYST 0124554256 COLLEAGUE

I have provided the above references to Molex Malaysia and am in full knowledge and agreement that Molex
Malaysia may contact these references as part of its application process.

QUALITY ENGINEER
______________________________ ____________________________
Candidate Acknowledgement Position Applied For

WAN ATIKAH BINTI WAN AZALAN


______________________________
Candidate Name (BLOCK LETTERS)

HRF-G015 Rev D (ARN# May014/12) Page 2


Important
List the last three employers whether or not it seems relevant to position applied for,
if lapses occurred between periods of employment, give dates and reason for unemployment below.
Present or Last Employer
Name of Employer Telephone No. if known
FLEXTRONICS

Address Nature of Business

Employment Dates (Month and Year) Name and Title of Immediate Supervisor
From : 05/2022 To : 10/2023 AS LOO, QUALITY DIRECTOR

Starting Base Salary Final Base Salary


Reason for Desiring Change or Leaving RM7200 RM7531

MSS, COMPANY DOWNSIZING Title of Position


SENIOR QA

Description of Duties Write 8D, investigate customer complaint, CAPA, RCCA

Previous Employer
Name of Employer JABIL CIRCUIT
Telephone No. if known

Address Nature of Business

Employment Dates (Month and Year) Name and Title of Immediate Supervisor
From : 09/2020 To : 05/2022 JONAS BAUTISTA, QUALITY AM

Starting Base Salary Final Base Salary


Reason for Desiring Change or Leaving RM5800 RM6200

BETTER OFFER Title of Position QA II

Description of Duties Write 8D, investigate customer complaint, CAPA, RCCA

Previous Employer
Name of Employer KAGA COMPONENT
Telephone No. if known

Address Nature of Business

Employment Dates (Month and Year) Name and Title of Immediate Supervisor
From : 10/2019 To : 08/2020
Starting Base Salary Final Base Salary
Reason for Desiring Change or Leaving RM4300 RM4300

COMPANY DOWNSIZING DUE TO COVID Title of Position AM QUALITY DEPARTMENT

Description of Duties Write 8D, investigate customer complaint, CAPA, RCCA

HRF-G015 Rev D (ARN# May014/12) Page 3

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