Doc. No.

: DY-HR-F11
Employment Application Form
Rev. No. : 1

SECTION A - FOR CANDIDATE

Personal Particulars
Position Applied : QC INSPECTOR
Full Name : AHMAD FIKRIL KHAIRI BIN SHAHARUDIN
NRIC / Passport No. : 950911-01-7647 Applicant Passport
Sex : MALE Size Photograph
Nationality : MALAYSIAN Required
Weight : 60 KG
Height : 170 MM
Valid Driving License : B, D
Marital Status : SINGLE Date of Birth : 11 SEPTEMBER 1995
Contact No. (H) : N/A Place of Birth : KUCHING, SARAWAK
Handphone No. : +6013 711 4176 Race : MALAY
Age : 27 Y O Religion : MUSLIM
Permanent Address : NO 906, JALAN PIALA, TAMAN SUKMA, PETRAJAYA, 93050, KUCHING, SARAWAK

Mailing Address : AHMADFIKRILKHAIRI@GMAIL.COM

Family Particulars
Name Contact Number Age Occupation Relationship
AHMAD SHAHIR BIN SHAHARUDIN 33 QAQC INSPECTOR BROTHER
SHAHARUDIN BIN ISMAIL 62 RETIRED FATHER
RABIAH BINTI TAHIR 65 RETIRED MOTHER

Emergency Contact
Name Address Contact Number Relationship
AHMAD SHAHIR BIN SHAHARUDIN 906, JLN PIALA, TAMAN SUKMA, 93050,KUCHING +6019 700 7363 BROTHER

Education/ Professional Qualification(s)

Period University/ College/ School Qualification/ Major/ Course Grade Remarks
2013 KOLEJ MARA KUALA NERANG FOUNDATION PASS
2014-2017 UNIKL MFI BACHELOR'S DEGREE IN MECH PASS (3.37)
2019-2020 UTM SKUDAI MASTER'S DEGREE IN MECH PASS (3.56)
2022 TWI SHAH ALAM CSWIP 3.1 WELDING INSPECTOR CERTIFIED exp.: JULY 2027
2020 INSTECH API 577 WELDING INSPECTION CERTIFIED exp.: FEB 2024
AND METALLURGY

Language Proficiency
Malay Speak : ( Slight / Fair /
O
FluentRead
)
O
: ( Slight / Fair / Fluent ) Write : ( Slight / Fair /
O
Fluent )
English
Mandarin
Speak
Speak
:
:
(
(
Slight
Slight
/
/
Fair
Fair
/
/
O
FluentRead
)
FluentRead
)
O
: ( Slight / Fair / Fluent
: ( Slight / Fair / Fluent
)
)
Write
Write
:
:
(
(
Slight
Slight
/
/
Fair
Fair
/
/
O
Fluent
Fluent
)
)
Others Speak : ( Slight / Fair / FluentRead
) : ( Slight / Fair / Fluent ) Write : ( Slight / Fair / Fluent )
Speak : ( Slight / Fair / FluentRead
) : ( Slight / Fair / Fluent ) Write : ( Slight / Fair / Fluent )

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 Doc. No. : DY-HR-F11
Employment Application Form
Rev. No. : 1

Employment History
Name of Company : OCEANMIGHT SDN BHD Tel. No. :
Type of Business : METAL FABRICATION Position Held : QAQC cum WELDING ENG
Last Drawn Salary : RM 6 000 + RM 1 000 From : 1 FEB 2021
Reason To Leaving : END OF CONTRACT To : 18 OCT 2022

Name of Company : Tel. No. :

Type of Business : Position Held :
Last Drawn Salary : From :
Reason To Leaving : To :

Name of Company : Tel. No. :

Type of Business : Position Held :
Last Drawn Salary : From :
Reason To Leaving : To :

References
Name Address / Telephone Period Known Occupation
Mr Wen C. Grabillo +6019 399 5802 2 YEARS QA/QC MANAGER

Declaration
Description Please Circle Provide Details if 'Yes'
Are you smoking? O
Yes / No
Have you ever been convicted on a criminal charge? O
Yes / No
Are you suffering from any illness/ physical disabilities? O
Yes / No
Do you have any pre-existing medical conditions? O
Yes / No
O
Have you ever been dismissed/ suspended by previous employers?Yes / No
Have you ever been declared bankrupt? O
Yes / No
Have you ever applied for any position(s) with our company? Yes / O
No
Do you know anyone currently working in this company? Yes / O
No
For female applicant, are you currently pregnant? O
Yes / No
How do you get to know of this vacancy? Yes / O
No
Have you completed your covid-19 vaccination? O
Yes / No

Expected Salary: RM 9 000 Earliest Date Available: 1ST NOVEMBER 2022

I certify that my answers are true and complete to the best of my knowledge. I hereby authorise Dynaciate to
make investigation/ inquiries as may be necessary and I release employers, schools or person from all liability in
responding to investigations/ inquiries in connection with my application. I understand that if any information
provided by me on this form or during interview(s) is false/ untruthful/ misleading , my contract of employment
may be nullified.

AHMAD FIKRIL 14/10/2022

Signature of Application Date

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 Doc. No. : DY-HR-F11
Employment Application Form
Rev. No. : 1

SECTION B - FOR INTERVIEWER USE ONLY

(Please tick any one)
New Position Replacement

Permanent Contract month(s)

site / project
Action: Engage Designation
KIV Department
Reject Company
Salary Offered Allowance Offered
Overtime Offered Commencement Date
Working Hour Alternate Saturday Off ( YES / NO )
Benefits:
YES Description of Benefits
(please tick)
* Company Car
* Hostel
* Desktop
* Laptop
*Others

Signature Approved by,

Interviewer Name: Name:

Date: Date:

SECTION C - FOR HR ONLY

To be fill up if application accepted.
Employee No.
Basic Salary
Designation
Grade
Allowance
Overtime
Commencement Date
Remark

Completed by,

Name:
Date:

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