CONFIDENTIAL

UEM EDGENTA BHD

EDGENTA MEDISERVE SDN BHD
EDGENTA HEALTHTRONICS SDN BHD
EDGENTA FACILITIES SDN BHD
EDGENTA PROPEL BHD
OPUS INTERNATIONAL (M) BHD
SOIL CENTRALAB SDN BHD

PERMOHONAN UNTUK PEKERJAAN

APPLICATION FOR EMPLOYMENT
Nota/Note:
1. Sila baca seluruh borang permohonan dengan teliti dan lengkapkannya dalam HURUF BESAR.
Please read through the application form carefully and complete it in BLOCK LETTERS. Gambar Terbaru
Latest Photograph
2. Selepas dilengkapkan borang ini hendaklah dikembalikan beserta dengan satu (1) keping gambar berukuran
paspot.
The application form upon completion is to be returned with one (1) passport size photograph.

3. Sila lampirkan salinan sijil-sijil/surat akuan bersama borang ini. Sijil-sijil asal hendaklah dibawa bersama
semasa temuduga.
Please attach copies of relevant certificates/testimonials to this form. Originals are to be
produced at the interview.

JAWATAN DIPOHON: Gaji yang dipohon:

POST APPLIED FOR: …………………………………………… Salary expected: ……………………….…………….

A. BUTIR-BUTIR PERIBADI/PERSONAL DETAILS

1. Nama Penuh: 2. E-mel :

Full Name: ……………………………………………………… Email …………………………………………………….

3. Alamat: …………………………………………………………. 4. No. Tel. (Rumah): ……………………………………….

Address: Tel. No. (House):
……………………………………………………………………….
No. Tel. (Pejabat/Bimbit) …..……………………………
………………………………………………………………………. Tel. No. (Office/Handphone):
5. Tarikh Lahir /Umur: ….……………………………………………. 6. Tempat Lahir: …………………………………………….
Date of Birth/Age: Place of Birth:

7. No. K.P./Pasport: …………………………………………………. 8. Tempat/Tarikh dikeluarkan: ………………………………

I.C./Passport No.: Place/Date Issued:

9. Warganegara: …………………………………. 10. Bangsa: ………………………….. 11. Agama: ………………….

Nationality: Race: Religion:

12. Bahasa: Pertuturan ………………………………………….. Tulisan ………………………………………………….

Languages: Spoken Written

13. No. KWSP: …………………….. 14. No. SOCSO: ……………………... 15. No. Cukai Pendapatan: ………………….
EPF No.: SOCSO No.: Income Tax No.:

16. Status Perkahwinan: Bujang/Kahwin 17. Nama Suami/Isteri: ………………………………………

Marital Status: Single/Married Name of Spouse:

18. Pekerjaan Suami/Isteri: …………………………………………. 19. Nama Syarikat: …………………………………………..

Occupation of Spouse: Name of Company:

20.
Butir-butir anak: Details of Children:

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 Jika belajar nyatakan
Nama/Name Umur/Age Jantina/Sex “Tanggungan”
If studying, indicate as
‘Dependant’

a. ……………………………………………. …………………… …………………………… ………………………………

b. ……………………………………………. …………………… …………………………… ……………….………………
c. ……………………………………………. …………………… …………………………… ……………….………………
d. ……………………………………………. …………………… …………………………… ……….………………………
e. ……………………………………………. …………………… …………………………… ….……………………………
f. ……………………………………………. ……………………. ……………………………. ……………………………….

B. BUTIR-BUTIR KELUARGA/FAMILY DETAILS

1. Nama Bapa: 2. Pekerjaan:

………………………………………………….. ……………………………………….
Father’s Name: Occupation:

3. Nama Emak: 4. Pekerjaan:

………………………………………………….. ……………………………………….
Mother’s Name: Occupation:

5. Nama adik-beradik/
Name of brothers and sisters Umur/Age Jantina/Sex Pekerjaan/Occupation

a. ……………………………………………. …………………… …………………………………. …………………………

b. ……………………………………………. …………………… …………………………………. …………………………
c. ……………………………………………. …………………… …………………………………. …………………………
d. ……………………………………………. …………………… …………………………………. …………………………
e. ……………………………………………. …………………… …………………………………. …………………………

C. BUTIR-BUTIR PENGAJIAN/EDUCATIONAL DETAILS

Nama Sekolah Tahun/Year Kelulusan Butir-butir Pencapaian

School’s Name (Dari/From Hingga/To) Qualification Grades Achieved

Nama Universiti/Kolej
University/College’s Name

Lain-lain Kursus
Other Courses Completed

Kursus yang sedang diikuti

Courses currently attending

Biasiswa yang pernah diterima Perbadanan/Institusi Jumlah/Nilai

Scholarships Received Organisation/Institution Amount/Value (RM)

D. KEGIATAN-KEGIATAN/ACTIVITIES

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Sekolah/Kolej/Universiti
School/College/University
Ahli Kelab, Persatuan dll.
Sukan/Permainan/Kegemaran Jawatan yang disandang
Membership of Clubs, Societies,
Sports/Games/Hobbies Positions held
Associations, etc.

Sekarang
At Present

E. PENGALAMAN BEKERJA/WORK EXPERIENCE

1. Pekerjaan Sekarang/Present Employment

Tarikh Bermula (Bulan/Tahun) ……………………………………………. Nama Syarikat ………………………………………………….

Date Joined (Month/Year) Company Name

Jawatan Sekarang ………………………………………………………….. Alamat ………………………………………………………….

Present Job Title Address
……………………………………………………………………
Melapur Kepada (Name dan Jawatan) …………………………………….
Reporting To (Name and Job Title) ……………………………………………………………………

Bilangan Kakitangan yang anda selia ……………………………………. ……………………………………………………………………

No. of Staff you Supervise
……………………………………………………………………
Bil. Kakitangan ……………….……………………………………………… Jenis Perniagaan …………………………………………………
No. of Employees Nature of Business

Gaji Permulaan ………………………… Gaji Sekarang …………………….. Elaun (Jenis dan Jumlah) ………………………………….
Starting Salary Present Salary Allowances (Type and Amount)

Sebab-sebab anda ingin memohon jawatan lain….………………………………………………………………………………………………………

Reason for applying for a new position.

Tarikh boleh Melapur Diri ………………………………………………

Notis Berhenti yang Diperlukan ……………………………………. Date Available for Employment
Resignation Notice Period Required

Tugas-Tugas Lukiskan Carta Organisasi dan Kedudukan Anda (Tandakan ‘x’)

Key Duties Complete and organization chart showing your position in the
organization (mark ‘x’)
…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

…………………………………………………………………………

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2. Lain-lain Pengalaman Bekerja/Other Relevant Work Experience
Gaji Terakhir
Dari Hingga Nama Syarikat Jawatan Sebab Meletakkan Jawatan
Last Drawn
From To Company Name Job Title Reason for Leaving
Salary

F. PERUJUK PERIBADI/REFEREES

Sila nyatakan nama, alamat dan jawatan dua orang perujuk peribadi yang bukan ahli keluarga pemohon.
List the names and contact details of two referees who are not members of your family.

Nama: ……………………………………………………………….
Name Nama: ……………………………………………………………….
Name
Pekerjaan: …………………………………………………………….
Occupation Pekerjaan: …………………………………………………………….
Occupation
No. Tel.: ……………………………………………………………….
Tel. No. No. Tel.: ……………………………………………………………….
Tel. No.
Hubungan: …………………………………………………………….
Relationship Hubungan: …………………………………………………………….
Relationship
Jawatan: ………………………………………………………………
Occupation: Jawatan: ………………………………………………………………
Occupation:
Tempoh dikenali: ……………………………………………………..
Years of Acquaintance Tempoh dikenali: ……………………………………………………..
Years of Acquaintance

G. AKUAN/DECLARATION

1. Adakan anda mempunyai lain sumber pendapatan sendiri? *YA/TIDAK

Have you any other independent means or source of income? *YES/NO

Jika ya, sila nyatakan punca dan nilai pendapatan tersebut.

If yes, please state the source and amount of income.

……………………………………………………………………………………………………………………………………………………..

2. a. Adakah anda menyandang jawatan pengarah di mana-mana syarikat? *YA/TIDAK

Are you a director for any companies? *YES/NO

b. Jika ya, sila nyatakan nama syarikat tersebut, jumlah saham yang dimiliki dan jawatan yang disandang.
If so, please state name of the Company, amount of shares owned and/or the positions you are holding.

………………………………………………………………………………………………………………………………………………

3. a. Adakah anda sekarang atau pernahkah anda memegang sebarang jawatan di dalam mana-
mana pertubuhan sosial, professional atau politik? *YA/TIDAK
Do you presently or have you ever held office in any political, social or professional *YES/NO
organisations?

b. Jika ya, sila nyatakan nama pertubuhan dan jawatan yang disandang.
If so, please give their names and the positions you are/were holding.

………………………………………………………………………………………………………………………………………………

4. Adakah anda seorang muflis atau pernah diisytiharkan muflis? *YA/TIDAK

Are you a Bankrupt or have you been ever been declared a Bankrupt? *YES/NO

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5. Adakah anda pernah didapati bersabit dengan sebarang kesalahan?
*YA/TIDAK
Have you ever been convicted for any offences?
*YES/NO
6. a. Adakah anda menghidapi penyakit yang serius dan/atau kecacatan? *YA/TIDAK
Do you have any major medical illnesses and/or disabilities? *YES/NO

b. Jika ya, sila nyatakan jenis penyakit yang dihidapi dan/atau kecacatan.
If so, please provide details on nature of your illness and/or disability.

………………………………………………………………………………………………………………………………………………

7. Adakah anda memiliki lesen memandu? *YA/TIDAK Jika ada, Kelas:

Do you possess a driving licence? *YES/NO If so, Class: ……………………….

8. a. Adakah anda mempunyai keluarga *bekerja dengan UEM Group atau lain-lain anak- *YA/TIDAK
syarikatnya? *YES/NO
Do you have any relatives *working with UEM Group, or any of its subsidiary companies?
*suami/isteri, ibubapa, anak-anak (termasuk anak angkat dan anak tiri) dan adik-beradik
*employee’s spouse(s), parents, children (including adopted or step children), brothers and sisters

b. Jika ada, sila berikan nama, hubungan dan jawatan jika diketahui.
If so, please give their names, relationships with you and present job, if known.

…………………………………………………………………………………………………………
9. a. Pernahkah anda memohon jawatan atau dipanggil untuk temuduga di UEM Group atau lain- *YA/TIDAK
lain anak syarikatnya sebelum ini? *YES/NO
Have you ever applied for jobs or attended any interviews at UEM Group or any of its
subsidiary companies before?

b. Jika ada, sila nyatakan tarikh dan jawatan yang dipohon atau yang dipanggil untuk temuduga.
If yes, please state date and position applied for or called for interview.

………………………………………………………………………………………………………………………………………………

*Potong yang tidak berkenaan/Delete which is not relevant

Saya mengaku bahawa maklumat di atas adalah benar pada pengetahuan saya. Selepas diterima bekerja jika diketahui yang saya telah memberi
maklumat yang palsu di dalam borang, pihak Syarikat berhak untuk menamatkan perkhidmatan saya.
I declare that the above information is, to the best of my knowledge, true and if after engagement it is found that I have made a false declaration on
the form, the Company reserves the right to terminate my services.

Tarikh: ……………………………………………. Tandatangan Pemohon: …………………………………………….

Date: Signature of Applicant:

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HR NOTES:

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