POSITION APPLIED FOR:

Job Application | Private & Confidential

eHATI INTERNATIONAL SDN BHD
JAWATAN YANG DIPOHON:
Recent
PERSONAL DETAILS Passport
Size
FULL NAME / NAMA PENUH Photograph
PREFERRED NAME / NAMA PILIHAN
CORRESPONDENCE ADDRESS / ALAMAT SURAT MENYURAT

RESIDENTIAL ADDRESS / ALAMAT KEDIAMAN

TELEPHONE NO. (H) / NO. TELEFON RUMAH

MOBILE NO. (HP) / NO. TELEFON BIMBIT
EMAIL / EMEL

DATE OF BIRTH / TARIKH LAHIR

PLACE OF BIRTH / TEMPAT LAHIR

TIME OF BIRTH / MASA LAHIR
GENDER / JANTINA M/L o F/P o AGE / UMUR

NRIC NO. (NEW) / NO. KAD PENGENALAN BARU

PASSPORT NO. (NON-MALAYSIAN) /

NO. PASSPORT (BUKAN WARGANEGARA)

NATIONALITY / WARGANEGARA
RACE / BANGSA RELIGION / AGAMA
INCOME TAX NO. / NO. CUKAI PENDAPATAN
EPF NO. / NO. KWSP

EMERGENCY CONTACT / NO. KECEMASAN

NAME / NAMA
MOBILE NO. / NO. TELEFON
RELATIONSHIP / HUBUNGAN

IMMEDIATE FAMILY DETAILS

MARITAL STATUS / TARAF PERKAHWINAN SINGLE / BUJANG o MARRIED / KAHWIN o
SPOUSE'S NAME / NAMA SUAMI/ISTERI
SPOUSE'S NRIC NO. / NO. KAD PENGENALAN SUAMI / ISTERI
INCOME TAX NO. / NO. CUKAI PENDAPATAN SUAMI / ISTERI
SPOUSE'S OCCUPATION / PEKERJAAN & MAJIKAN SUAMI / ISTERI
CHILDREN / ANAK-ANAK
NAME/NAMA AGE / UMUR
1

6
 Job Application | Private & Confidential
eHATI INTERNATIONAL SDN BHD
FATHER'S NAME / Nama Bapa
OCCUPATION / PEKERJAAN

MOTHER'S NAME / Nama Ibu

OCCUPATION / PEKERJAAN

SIBLINGS / ADIK BERADIK

NAME / NAMA AGE / UMUR JOB / PEKERJAAN
1

EDUCATION / CURRENT QUALIFICATIONS

INSTITUTION QUALIFICATION YEAR COMPLETED
INSTITUSI / SEKOLAH KELAYAKAN TAHUN SELESAI

OTHER ACHIEVEMENTS / PENCAPAIAN LAIN

Note: Please attach copies of relevant certificates

Nota: Sila lampirkan sijil-sijil yang berkenaan

SKILLS, HOBBIES, INTERESTS & TALENTS / KEMAHIRAN, HOBI, MINAT & BAKAT

LANGUAGE / DIALECTS BAHASA / LOGHAT

SPOKEN /
WRITTEN / MENULIS
PERTUTURAN

BAHASA MALAYSIA * Please indicate proficiency

* Sila catitkan taraf kemahiran
ENGLISH / BAHASA INGGERIS 1 = Excellent / Amat Baik
2 = Good / Baik
OTHERS / LAIN-LAIN 3 = Fair / Sederhana
 PREVIOUS EMPLOYMENT (MOST RECENT FIRST PLEASE)

Job Application | Private & Confidential

eHATI INTERNATIONAL SDN BHD
PEKERJAAN TERDAHULU (TERBARU DAHULU)

JOB TITLE / YEAR FROM - TO

EMPLOYER / ESTABLISHMENT REASONS FOR LEAVING
DESIGNATION TAHUN DARI -
MAJIKAN SEBAB BERHENTI
JAWATAN HINGGA

HEALTH DECLARATION / AKUAN KESIHATAN

Are you aware of any circumstances regarding your health or capacity to work which may impact
your ability to perform the duties of the position?
Yes o
Adakah anda mengetahui sebarang keadaan berkaitan kesihatan atau keupayaan anda untuk No o
bekerja yang boleh menjejaskan keupayaan anda untuk melaksanakan tugas jawatan tersebut?
Jika ya, sila berikan butiran
If yes, please provide details / Jika ya, sila berikan butiran

Do you have an existing injury or medical condition or pre-existing injury or medical condition
that could be affected by the nature of the proposed employment?
Yes o
Adakah anda mengalami kecederaan atau keadaan perubatan sedia ada atau kecederaan sedia No o
ada atau keadaan perubatan yang boleh dipengaruhi oleh jenis pekerjaan yang dicadangkan?

If yes, please provide details / Jika ya, sila berikan butiran

Have you ever worked with any substances or in any conditions which may have been hazardous
to your health (e.g. asbestos exposure, toxic chemicals, stressful or noisy environments) and may
Yes o
impact your ability to perform the duties of the position and for which you need a modified No o
workplace?
Pernahkah anda bekerja dengan apa-apa bahan atau dalam apa-apa keadaan yang mungkin
berbahaya kepada kesihatan anda (cth pendedahan asbestos, bahan kimia toksik, persekitaran
yang tertekan atau bising) dan boleh menjejaskan keupayaan anda untuk melaksanakan tugas
jawatan dan yang anda perlukan tempat kerja yang diubah suai?
If yes, please provide details / Jika ya, sila berikan butiran

Are you required to take medication which may impact on your ability to perform the duties of
the position?
Yes o
Adakah anda dikehendaki mengambil ubat-ubatan yang boleh menjejaskan keupayaan anda No o
untuk melaksanakan tugas-tugas jawatan tersebut?
If yes, please provide details / Jika ya, sila berikan butiran

Are you currently pregnant? Adakah anda sedang hamil? Yes o

If yes, please provide details / Jika ya, sila berikan butiran No o
 Job Application | Private & Confidential
eHATI INTERNATIONAL SDN BHD
1. If offered employment, please state / Jika ditawarkan pekerjaan, sila nyatakan:
(a) Period of notice you are required to give present employer / Tempoh notis
yang perlu diberi kepada majikan sekarang

(b) Basic salary you would expect to earn per month / Gaji bulanan yang
RM
dipohon

(c) Other benefits expected / Faedah lain yang diharapkan

2. Please provide any other information that you identify as being pertinent to this application? (for example,
medical conditions, disabilities) / Sila berikan sebarang maklumat lain yang anda kenal pasti

REFERENCES / RUJUKAN

Please provide two(2) persons (One personal reference and one employee/colleague reference. Not be relatives.)
Sila berikan butir-butir dua orang penyokong. Satu rakan sekerja dan satu rujukan peribadi (bukan saudara-mara).

1. FULL NAME / NAMA PENUH

MOBILE NO. / NO. TELEFON

YEARS KNOWN OCCUPATION /

Bil.Tahun Mengenali JAWATAN
2. FULL NAME / NAMA PENUH

MOBILE NO. / NO. TELEFON

YEARS KNOWN OCCUPATION /

Bil.Tahun Mengenali JAWATAN

DECLARATION / AKUAN

I declare that to the best of my knowledge the information given is true and correct. I understand that inaccurate,
misleading or untrue statements or knowingly withheld information may result in termination of employment with
this organisation. I understand that this application does not constitute an offer of employment. I understand that,
in some cases, police and credit checks will be required and I will be notified if this applies to this application.

Saya mengaku bahawa sepanjang pengetahuan saya, maklumat yang diberikan adalah benar dan betul. Saya
faham kalau ada maklumat yang saya kemukakan, tidak tepat, mengelirukan atau kenyataan yang tidak benar atau
maklumat yang disimpan secara sedar boleh mengakibatkan penamatan pekerjaan dengan organisasi ini. Saya
faham bahawa permohonan ini bukan merupakan tawaran pekerjaan. Saya faham bahawa, majikan boleh
membuat semakan polis dan semakan kredit akan diperlukan dan saya akan dimaklumkan jika ini berkaitan
dengan permohonan ini.

SIGNATURE / TANDATANGAN DATE / TARIKH

 FOR OFFICE USE ONLY / UNTUK KEGUNAAN PEJABAT SAHAJA

INTERVIEW REMARK / COMMENTS BY INTERVIEWER(S) / HIRING MANAGER

CATATAN TEMUDUGA / ULASAN OLEH PENEMUDUGA / PENGURUS

INTERVIEWED BY / PENEMUDUGA
NAME / NAMA

DEPARTMENT / BAHAGIAN

SIGNATURE / Tandatangan

TO HIRE / UNTUK BEKERJA

CANDIDATE JOB TITTLE / DESIGNATION

DIVISION / DEPARTMENT

RECOMMENDED SALARY JOB GRADE

COMMENCEMENT DATE

EMPLOYMENT TYPE 1. Full Time Contract o 2. Part Time Contract o

3. Fixed-Term Contract o 4. Contract for Service o

REMARKS / CATATAN

APPROVED FOR HIRE

DATE APPROVED AUTHORISER'S SIGNATURE

NAME:

DESIGNATION: