PERSONAL PARTICULARS
Full Name (with qualifications in brief):
Date of Birth:
Place of Birth:
Nationality:
Citizenship:
Marital Status:
Religion:
Sex:
Country of
Domicile:
Passport No.:
Expiry Date:
Address of
correspondence:
Telephone [Office]:
E-Mail:
Telephone [Home]:
Fax No.:
Present Post:
Basic Salary:
Other Emoluments and Allowance etc:
Period of Notice before Reporting for Duty in Brunei:
Attach
passport-size
photograph
here
UBD/LC/001
Post School Qualifications: (with institutions attended, dates and brief details of subjects, grades and qualifications)
Faculty/School/Department:
Duties:
Current Position of
Responsibility [e.g. Head of
Department]:
Previous Posts and Responsibilities in this Institution:
Name of Institution
Nature of Employment
Name of Institution
Nature of Employment
Other Employers:
Positions held
Supervision Experience: Please indicate and provide list of supervision at undergraduate level (such as final year
projects) and postgraduate level (Masters degree and PhD students)
LANGUAGES
Fluent
Written Ability
Good
Fair
Fluent
Spoken Ability
Good
Fair
Malay
English
Arabic
Others:
FAMILY PARTICULARS
Children Name
Date of Birth
Sex
1.
2.
3.
4.
Applicants Spouse [Indicate briefly, if you wish your spouses occupation and qualifications and possible
employment interest in Brunei [this does not imply that any such employment is available].
Full Name :
REFEREES
Give details of three referees [including position and qualifications], stating whether they may be contacted at this
stage. Please include telephone, fax numbers and email address.
1.
2.
3.
I declare that the particulars in this application and the attached sheets hereto are true to the best of my knowledge
and belief, and that I have not wilfully withheld any material fact.
Signature :
Date:
Notes
(1) A letter of application and any further details may be attached.
(2) Attach a recent photograph to each copy of this application form.