STRICTLY CONFIDENTIAL

EMPLOYMENT APPLICATION FORM

Position Applied For
Full Time Part Time
Affix Photo
Interview Session First Interview Second Interview (if applicable)
Here
Interviewer
Date (dd/mm/yyyy)

PERSONAL PARTICULARS

Full Name : Dr. Mr. Mdm. Miss

Chinese Character (if any)
(underline surname) As in NRIC / Passport
NRIC / FIN No.: Permanent Address :
Citizen PR Foreigner
Nationality / Citizenship :
Date of Birth (dd/mm/yy) :
Gender : Correspondence Address :
Marital Status :
Driving License : Class 2A / 2B / 3 / 4 / 5
Own a Vehicle : Yes No
Language Proficiency (Poor, Basic, Fluent)
Spoken Written Read
Type of Language(s) Email Address :
P B F P B F P B F
(H/P) :
Tel (Home) :
(Office) :

EDUCATIONAL DETAILS

Date Date Highest Standard Passed

Level School / Institution Country Joined Graduated (Grade/Degree & Field of Study)
Primary
Secondary
Poly / College
University
Others
Details of Education or Training presently pursuing / or intend to pursue in the next six months.
Expected Date
Particulars Start Date of Completion

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Other Academic or Professional Qualifications (including Training Courses Attended) :
Particulars / Professional Designation Year Membership
Institution
Obtained From To Status

PROFESSIONAL MEMBERSHIP

Name of Professional Body Membership Position Date Admitted

EMPLOYMENT HISTORY

Start End Basic Salary

Allowance Reason(s) For
Company Date Date Position Held Last
Start (if any) Leaving
(mm/yy) (mm/yy) Drawn

Indicate past / present duties and responsibilities relevant to position applied for :

a) Past Employers Yes No

Do you have any objection to a reference being made to your :
b) Present Employer Yes No
What is the length of notice you are required to terminate your present employment?
If appointed, what is your expected salary?

PROFESSIONAL REFEREES (Either Previous Or Current Superior / Manager)

Full Name : Full Name :

Company Name : Company Name :
Occupation : Occupation :
Relationship : Relationship :
Years Known : Years Known :
Contact No. : Contact No. :

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 OTHER INFORMATION

Have you been employed previously by Johnson Controls*?

If yes, when and name of Company. Yes No

Do you have any friends / immediate relatives (whether related by blood or marriage) working in
Johnson Controls / vendors / sub-contractors? If yes, please give details (name / relationship / position).
Yes No

Have you applied previously to join Johnson Controls?

If yes, please state the position and year. Yes No

Do you have any history of illness or medical problems?

If yes, please give details. Yes No

Are you currently serving any bond?

If yes, please give details. Yes No

Do you think in any circumstances that the job you applied for will not be suitable given your past
medical conditions e.g. stress level, physical demands (e.g. carry heavy equipment / tools) and etc. Yes No

Have you ever been discharged, dismissed or retrenched from service of past employers?
If yes, please give details. Yes No

Have you ever been declared a bankrupt or are you an un-discharged bankrupt as of today?
If yes, please give details. Yes No

Have you ever been arrested for or charged with any criminal offence within or outside Malaysia or held
by any law enforcement agency for violation of any law?
Yes No
If yes, please give details.

Please state any other information that you wish to disclose that may help support your application.

Please give us a candid account of your personal qualities, both strengths and weaknesses, your career objectives and what makes you
suitable for this job.

*Note: Johnson Controls / The Company in this application form refers to Johnson Controls (M) Sdn Bhd, York (Malaysia) Sales &
Service Sdn Bhd, York (Malaysia) Manufacturing Sdn Bhd or Tyco Fire, Security & Service Malaysia and any of its subsidiaries.

DECLARATION & CONSENT STATEMENT

I declare that the information given to Johnson Controls (the “Company”) in this application form is true and correct. Any false or
misrepresented information will render my application null and void; and if employed, I understand and agree that my employment shall
be terminated by the Company with immediate effect.

I agree to sign and be bound by the Personal Data Consent Statement set out below in this application form.

Date (dd/mm/yyyy) Signature of Applicant

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 Personal Data Consent Statement

1. Without limiting the rights of the Company under and subject to applicable law, by signing above, I consent to the Company, any
Affiliate and any third party acting on its or their behalf:

(a) Processing my Personal Data for any purpose directly or indirectly connected with:

(i) my application for employment with the Company including but not limited to background and reference checks;
evaluation for job suitability, eligibility or qualifications; medical checks; recruitment or hire; retention of my Personal
Data for future job position in the Company or any Affiliate; and/or

(ii) compliance with applicable laws and regulations and/or legal proceedings.

(collectively the "Purposes"); and

(b) Processing including Transferring my Personal Data outside Malaysia for such Purposes,

during and for a reasonable period after my application for employment to the Company, in accordance with Company policy and to
the extent permitted by law.

2. I agree that Processing my Personal Data is necessary and is a condition of my application for employment and the Company is
unable to proceed with and/or consider my application if I do not agree to provide my Personal Data or to Processing my Personal
Data as required herein.

3. I agree to provide to the Company, any Affiliate and any third party acting on its or their behalf, Personal Data relating to third
parties including but not limited to my family members ("Third Parties") to be Processed for any of the Purposes as and when
required by the Company. I confirm that I have obtained and/or will have obtained the consent of such Third Parties to the
Processing of their Personal Data on or before providing their Personal Data as required.

4. For the purposes of this Consent Statement:

“Affiliate” means corporation, entity or other organisation which:

(i) is directly or indirectly controlled by the Company;

(ii) directly or indirectly controls the Company; or

(iii) is directly or indirectly controlled by a third party who also directly or indirectly controls the Company,

and where the term “control” when used with respect to any organisation means the possession, directly or indirectly, of power to
direct or cause the direction of the management and policies of such organisation, whether through the ownership of shares or by
contract or otherwise.

"Personal Data" refers to data, whether true or not, about an individual who can be identified from that data, or from that data in
combination with other information to which the organisation may have access.

"Processing" includes recording, holding, organisation, adaptation or alteration, retrieval, combination, transmission, erasure,
destruction, obtaining, copying, amending, adding, deleting, extracting, storing, disclosing, Transferring or destruction of Personal
Data, and "Process" has the corresponding meaning.

"Transferring" refers to transferring Personal Data outside of Malaysia, whether by electronic (e.g. cloud storage, email, etc.) or
physical means (e.g. shipping physical files).