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Passport
1 Claymore Drive #02-03
Photograph
Singapore 229594 APPLICATION FOR EMPLOYMENT
Main: 6911 0533

Position Applied For Date of Application Expected Salary

In Block Letters: First Name Last Name Alias (If Any)

Permanent Address: Tel(R):

Date Of Birth: Place of Birth: Religion: Race/Dialect: Tel(H/P):

Citizenship: NRIC/Passport No: Martial Status: Height: Weight:

Email: Possess own vehicle? Driving License: Yes / No

Yes / No Class: 2B /2A / 2 / 3 / 3A / 4A / 4 / 5

FAMILY PARTICULARS (If married, list spouse & children / If single, list parents, brothers/sisters)

Name Relationship Age Level of Education Occupation

EDUCATION: Name of School From To Qualification Obtained

Primary

Secondary

College/Others

Polytechnic

University

List Business and Professional Memberships: Hobbies, Sports and Games:

EMPLOYMENT HISTORY (List Latest Job First)

From To Name of Company Salary Position Reasons For Leaving

 SPOKEN WRITTEN
LANGUAGES & DIALECTS
(Tick Appropriate Boxes) (Tick Appropriate Boxes)
Slight Fair Fluent Slight Fair Fluent
English
Others, please indicate:

Others, please indicate:

For Personnel Dept List

PERSONAL REFERENCES (Two persons who should not be your relatives)
Only
Name and Address Years Reference Request
Tel. No. Position
Known

NATIONAL SERVICE
Date Join Date Discharge Length of Service Rank

Vocation Held Partime/Fulltime N.S Remarks

HEALTH
Any Physical defects or Speech Hearing Sight Limbs
impairments Yes / No Yes / No Yes / No Yes / No
Have you ever suffered back injury? Do you wear glasses? High blood pressure?
Yes / No Yes / No Yes / No
Do you now have or have you ever Tuberculosis Diabetes Heart Trouble Dizzy spells
had any of the following: Yes / No Yes / No Yes / No Yes / No
Have you ever suffered any serious illness or disease? If so, explain brieftly. Epilepsy
Yes / No

Are you a drug addict? Have you ever been convicted in a court of law in any country?
Yes / No Yes / No

Do you have a relative now employed by us? Incase of emergency, notify:

Name:
Relationship: Address:

Relationship: Telephone No.

APPLICANT PLEASE READ CAREFULLY:

I hereby certify all information given in this Application form is true and correct.
I agree not to hold Nucleo Consulting Pte Ltd liable in any respect If my application is rejected or employment
terminated due to falsity of answers or omissions.
I authorize Nucleo Consulting Pte Ltd to secure any information regarding myself and hereby release any person, firm
or institution from all liability for any damage whosoever for issuing such information.
Finally, it is understood that if engaged, my employment may be terminated at any tie either by myself or FMC without
assigning any reasons whatsoever.

Applicant's Signature Date