Application Form

Page 1 of 4
Your Total Telecommunication & IT Solution

Please
attached
APPLICATION FOR EMPLOYMENT recent
photo
POSITION APPLIED FOR :
PERSONAL PARTICULARS
Full Name as per IC ( Underline surname, for married women, state also maiden name) Chinese Characters Name (if applicable)
Home Address Income Tax No.
EPF No.
Citizenship : Gender : Office Tel. No.
NRIC/Passport No : Marital Status : Home Tel. No.
Age : Dialect Group : Mobile No.
Date of Birth : Religion : E-Mail :
Place of Birth : Height (cm) : Weight (kg) :
EDUCATION ( From secondary education onwards)

Dates Major in / Highest Level Attained
School, College & University
From To Qualification Obtained (indicate subjects with distinctions gained)
Professional/Technical qualifications (with dates of awards)
Special training courses (with dates)
Present membership of professional, sosial and sporting organisations
ENCLOSURES
Please enclose :
(a) 1 passport size photograph & photocopy of IC
(b) Photocopies of detailed professional, university, "O" and "A" level results.
(c) Photocopies of latest salary slip
(d) Photocopies of latest resume
WORKING EXPERIENCE Page 2 of 4
Give particulars starting with present employer. If there is insufficient room, please continue on a separate sheet.
Date Position Name and address of employer Salary drawn Reason for leaving
From To ( State also type of business ) Start Current
What is your reason for

seeking a new appointment?
Have you ever been discharge from a job

If so, for what reason ?
How soon would you be available to

take up a new appointment?
Salary required (RM)
LANGUAGE PROFICIENCY
Spoken Written
Languages / Dialects Others
Fluent Good Fair Good Average Poor
SPECIAL SKILLS ( List all key pertinent skills and equipment you can operate )
1. Technical Skills ( work-related skills )
2. Soft Skills ( interpersonal communication )
3. Computer Knowledge ( hardware / software )
OTHER INFORMATION
Please give details of the important aspects of your experience to date and any additional information you consider relevant.
Page 3 of 4
Please answer to : ( YES or

OTHER INFORMATION NO ) in the box below
Have you been or are you suffering from any handicap or major disease/illness?
If yes, please provide medical history.
Type of handicap/illness : Duration suffered
Have you been convicted or criminal offence, or currently under legal proceeding pending court decision?
If yes, please provide details.
Offence convicted : Date
Have you ever been dismissed or suspended from employment?

If yes, please provide details
Reason : Date
Have you ever charged under Bankruptcy Act?
DETAILS OF SPOUSE
Name : Mobile No. :
Occupation :
Name of company : Tel. No. :
( referees will NOT be approached without your permission; we can have the option to do a back ground check
REFERENCES
including police reference if necessary. )
Employment References from past and present employment.
1. Name of referee
Position
Company Name, address
and telephone number
2. Name of referee
Position
Personal Reference
3. Name of referee
Position
DECLARATION
I declare that the particulars given in this application and the attachments are true and accurate the best of my knowledge and belief.
I understand that omissions or any false statements made by me on this application will be sufficient grounds for immediate termination.
Signature of Applicant Date

Page 4 of 4
FOR OFFICE USE ONLY

Assessment
Factors Excellent Above Satisfactory Satisfactory Below Satisfactory
1 JOB KNOWLEDGE
2 COMMUNICATION
3 SENSE OF RESPONSIBILITY
4 INTEGRITY ( CONFIDENTIALITY)
5 PRIDE (ATTITUDE)
6 RESPECT
7 PRINCIPAL & CUSTOMER FOCUSED
8 INITIATIVE TO SOLVE PROBLEM
9 WORKING WITH OTHERS (TEAMWORK)
10 WILLING TO LEARN
11 MULTI TASK HANDLING
12 ABLE TO WORK UNDER PRESSURE
Remarks by Interviewer
Name : _______________________ Designation : _______________________ Signature : ___________________ Date : _____________
Remarks by Interviewer (2nd)
Remarks by Head of Department concerned
APPOINTMENT
Designation
Salary Grade Allowance / Reimbursement :
Commencement Date : Probation Period :
Termination Period (for Contract Staff) : Start : End :
Special Conditions

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Page 1 of 4

Your Total Telecommunication & IT Solution

Home Address Income Tax No.

Citizenship : Gender : Office Tel. No.

NRIC/Passport No : Marital Status : Home Tel. No.

Age : Dialect Group : Mobile No.

Date of Birth : Religion : E-Mail :

Place of Birth : Height (cm) : Weight (kg) :

EDUCATION ( From secondary education onwards)

Professional/Technical qualifications (with dates of awards)

Special training courses (with dates)

Present membership of professional, sosial and sporting organisations

What is your reason for

Have you ever been discharge from a job

How soon would you be available to

Salary required (RM)

1. Technical Skills ( work-related skills )

2. Soft Skills ( interpersonal communication )

3. Computer Knowledge ( hardware / software )

Please answer to : ( YES or

Offence convicted : Date

Have you ever been dismissed or suspended from employment?

Have you ever charged under Bankruptcy Act?

Name of company : Tel. No. :

Signature of Applicant Date

FOR OFFICE USE ONLY

Name : _______________________ Designation : _______________________ Signature : ___________________ Date : _____________

Remarks by Interviewer (2nd)

Name : _______________________ Designation : _______________________ Signature : ___________________ Date : _____________

Remarks by Head of Department concerned

Name : _______________________ Designation : _______________________ Signature : ___________________ Date : _____________

Salary Grade Allowance / Reimbursement :

Commencement Date : Probation Period :

Termination Period (for Contract Staff) : Start : End :

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