STAFF RECRUITMENT FORM

Application for the post of:

A. PERSONAL PARTICULARS

Name as in I/C: _____________________________________________________ Aliases: _________________________

Residential address: __________________________________________________________________________________

_____________________________________________________________________________________________

Tel No. (Res.): ______________________ Hand-phone No.: _________________________ Race: _______________

Nationality: ______________________ I/C No.: ______________________________ Religion: ____________________

Date of Birth: _____/____/________ Age: _______ years Marital Status: ________________No. of Child: _________

EPF No.: ______________ Income Tax File No: __________________________SOCSO No.: _____________________

Bank Account No.: _____________________________________________ Name of Bank: _______________________

Driving License: YES / NO Class: ______________ Experience: _____________ years Own vehicles? Y /N

Languages/ Dialects: (Written) 1. _____________________ 2. ______________________3. _____________________

(Spoken): 1. _____________________ 2. _____________________ 3. _____________________

B. IN CASE OF EMERGENCY
Contact Person Relationship Address Contact No.

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C. EDUCATION AND TRAINING
From To
School / College / University Highest Standard Achieved
(year) (year)

D. PRESENT / MOST RECENT EMPLOYMENT

Name of Employer: _________________________________________________________________________________

Address: ___________________________________________________________________________________________

Postcode: ____________State: _______________________ Telephone No.: ______________________________

Present Position: ____________________________________ Since: _______________________________________

Initial Position: ________________________________ Since: _______________________________________

Present Salary: RM___________________________________ Allowance: RM______________________________

Other Benefits: _____________________________________________________________________________________

Immediate Superior’s Name & Position: ______________________________________________________________

Present Job Description: ____________________________________________________________________________

E. PREVIOUS EMPLOYMENT (START FROM FIRST EMPLOYER)

Company & Address From (year) Position Last Salary Reason for Leaving
To (year)

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F. DECLARATION
1. Have you suffered from any serious illness / injury / accident?
( ) NO ( ) YES If YES, please specify____________________________________

2. Have you been criminally convicted?

( ) NO ( ) YES If YES, please specify____________________________________

3. Have you been declared a bankrupt?

( ) NO ( ) YES

G. OTHER INFORMATION
1. If offered employment, are you prepared to be transferred to any of the IDPM associate companies /
subsidiaries?
( ) NO ( ) YES

2. What period of notice for termination of services are you required to serve on your present employer?
____________________________

3. What is your expected salary? RM _____________________ negotiable? YES / NO

I hereby certify that the information supplied on this form is true and complete to the best of my
knowledge. I understand that any false statement, or any omission of information herein requested will be
deemed good cause for separation under the terms and conditions of agreement of employment, which
I will sign in conjunction with this application.

__________________________
(Signature of Applicant)

Name:

Date:

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