SELEKSI SURIA SDN BHD

EMPLOYMENT APPLICATION
PERMOHONAN PEKERJAAN

Photo

Position Applied For / Memohon untuk Jawatan:(1) _____________________ (2) _____________________

PERSONAL PARTICULARS / MAKLUMAT PERIBADI
Name as in NRIC / Passport / Nama seperti dalam KP:

Other Name / Nama Lain:

NRIC / Passport No. / No Kad Pengenalan / No Passport:

NRIC Color / Warna Kad Pengenalan:

Pink / Merah jambu
Blue / Biru

Nationality / Warganegara:

Place of Birth / Tempat Lahir:

Date of Birth / Tarikh Lahir:

Age / Umur:

Gender / Jantina:

Marital Status / Taraf Perkahwinan:

Race / Bangsa:

Religion / Agama:

Dialect / Loghat:

Driving License No / No Lesen Memandu:

Tel No. (Home) / Nombor Telefon (Rumah):

(Handphone) / Telefon Bimbit:

Local Address / Alamat Tempatan:

Overseas Address (if any) / Alamat Luar negara (Jika ada):
Overseas Tel No. / Nombor Telefon Luar Negara :

Email / Emel:

In case of Emergency / Pada Waktu Kecemasan

Person to contact / Orang untuk dihubungi :

Relationship / Hubungan :

Address / Alamat:

Tel No. / Nombor telefon :

ACADEMIC AND PROFESSIONAL QUALIFICATIONS / AKADEMIK DAN KELAYAKAN TERTINGGI

Date(mm/yy) / Tarikh
From /
To /
Dari
Sehingga

Name of School / College / University Attended

Nama Sekolah / Kolej / Universiti

Highest Qualification Attained

Kelayakan Tertinggi

FOR INTERVIEWER , APPROVAL USE ONLY / UNTUK PENEMUDUGA , KEPUTUSAN SAHAJA

Interviewed by / Temuduga oleh: _____________________ Branch / Date / Cawangan/Tarikh: ________________________________
Outcome of Interview / Keputusan Temuduga:
Reject / Ditolak
KIV / Dalam Perhatian
Hire for Branch / Diterima untuk Cawangan: ____________________________
Salary / Allowance / Gaji/Alaun: ______________________________
Training Venue / Tempat Latihan: _________________________
Remarks / Ulasan: _____________________________________________________________________________________________

FOR HR USE ONLY / UNTUK KEGUNAAN SUMBER MANUSIA SAHAJA

Commencement Date / Tarikh Permulaan: ________________________
Remarks / Ulasan: _____________________________________________________________________________________________

HR001_EMPLOYMENT APPLICATION

Page 1 of 3

COMPUTER KNOWLEDGE / PENGETAHUAN KOMPUTER

Excellent /
Sangat baik

Good / Baik

Average / Sederhana

Poor / Lemah

Microsoft Word
Microsoft Excel
Microsoft Power Point
Adobe Photoshop

ACTIVITIES / AKTIVITI
1) Hobbies
1) Hobi

3) Club Association
Membership
3) Ahli Kelab Persatuan

2) Name of Scholarship / Prizes / Awards

2) Nama Biasiswa / Hadiah / Pingat

4) Others
4) Lain-lain

LANGUAGE PROFICIENCY / BAHASA

Language /
Bahasa

Excellent /
Sangat Baik

Written / Penulisan
Good /
Average /
Baik
Sederhana

Poor /
Lemah

Excellent /
Sangat Baik

Spoken / Percakapan
Good /
Average /
Baik
Sederhana

Poor /
Lemah

EMPLOYMENT HISTORY / PENGALAMAN KERJA

Date (mm/yy)
Tarikh (bb/tt)
From
Dari

To
Sehingga

Name of Employer
Nama Majikan

Expected Salary / Gaji di anggarkan: RM

Job Title /
Jawatan

Last Drawn Salary (RM) /

Gaji terakhir (RM)
Basic Salary /
Gaji Bersih

Reason for leaving /

Alasan berhenti

Other Allowances /
Lain-lain elaun

Date of Availability / Tarikh mula:

FAMILY PARTICULARS / LATARBELAKANG KELUARGA

Name / Nama

HR001_EMPLOYMENT APPLICATION

Age / Umur

Relationship / Hubungan

Occupation / Pekerjaan

Page 2 of 3

Tel No / No Telefon

REFERENCES / RUJUKAN
Name / Nama:

Relationship / Hubungan:

Company Name / Nama Syarikat:

Job Title / Jawatan:

Tel No. / No telefon:

Years Known / Tahun kenalan:

Name / Nama:

Relationship / Hubungan:

Company Name / Nama Syarikat:

Job Title / Jawatan:

Tel No. / Nombor Telefon:

Years Known / Tahun kenalan:

MEDICAL HISTORY / SEJARAH PERUBATAN

Yes No

Any Physical Disability / Adakah Anda Orang Kurang Upaya?:

If yes, please state / Jika ia sila jelaskan: ___________________
Any Major Illness / Accident? / Mempunyai penyakit serius / Kemalangan?
If yes, please state / Jika ia, sila jelaskan: ___________________

Yes No

OTHERS / LAIN-LAIN
1. Are you able to work shift? (Applicable to shift employees only) / Adakah anda mampu bekerja dalam pertukaran waktu?

Yes No

2. Have you completed National Service? (if any) / Adakah anda telah menamatkan Program Khidmat Negara(jika berkenaan)

Yes No

3. For female applicant, please specify if you are pregnant / Untuk pemohon wanita, adakah anda mengandung?

Yes No

4. Are you currently serving a bond? If yes, please state / Adakah anda terikat dengan mana-mana bon?Jika ada ,sila isikan:
Expiry date / Tamat tempoh: __________________ Amount of bond / Jumlah bon: RM ___________________

Yes No

5. Have you ever been declared bankrupt? / Adakah anda diisytihar muflis?

Yes No

6. Have you ever been convicted in a Court of Law in any country? / Adakah anda pernah mendapat tindakan mahkamah?

Yes No

7. Do you have any relatives/friends presently employed by our company? If yes, please state. /

Yes No

Adakah anda mempunyai saudara / kenalan yang bekerja di syarikat ini? Jika ada tolong isikan:
Name / Nama: ___________________ Dept./ Bahagian.: ___________________ Job Title / Jawatan: ___________________

KNOWLEDGE OF POSITION THROUGH:- / CARA MENGETAHUI TENTANG JAWATAN INI

Walk-In / Sedang Mencari

Newspaper / Suratkhabar
Please state / Sila isikan:
________________

Internet / Internet
Please state / Sila isikan: ______________

Recruitment Agency / Agensi

Please state / Sila isikan: ________________

Others / Lain-lain:
Please state / Sila isikan: ______________

Referral / Pemberitahu
Please state name of referral /
Isikan nama Pemberitahu:
________________

DECLARATION / PENYATAAN
I declare that the above information as provided by me is true, complete and accurate to the best of my knowledge.
I further understand that any willful act on my part in withholding information or making any false statement in this
Employment Application is in itself sufficient ground for dismissal from the Company.
Saya bersetuju mengenai kenyataan saya diatas telah lengkap dan tepat.
Saya faham sekiranya saya telah membuat kenyataan palsu mengenai diri saya di dalam Permohonan Pekerjaan, saya akan di pecat
dari syarikat ini.

Signature of Applicant
Tandatangan Pemohon

HR001_EMPLOYMENT APPLICATION

Date
Tarikh

Page 3 of 3