MB Scholarship Form
MB Scholarship Form
MB Scholarship Form
Personal Information
Name :
Address :
City : State :
Race : Age :
Religion : Nationality :
Education
Name of institution & Level Of Results
location Education
Maths
Please specify for 2 other
Grade : subjects with credit :
Vocational/Technical SPMV
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College/University DIPLOMA CGPA:
Language Proficiency
Language Spoken Written
English
Bahasa Melayu
Chinese
Tamil
( Please indicate the level of proficiency : Poor, Good or Excellent )
Curricular Activities
Types of Activities Position and Responsibilities Held
Additional Information
Have you ever been convicted of a misdemeanor or a felony?
Yes No
If yes, please provide details
________________________________________________________
Do you have any friends/relatives working with MBM and/or our affiliated
companies? Yes No
If yes, please provide details
________________________________________________________
Have you ever applied for this program/a job with MBM before?
Yes No
If yes, please provide details
________________________________________________________
Have you ever applied for any Degree or Diploma courses in University/College?
Yes No
If yes, please provide details
________________________________________________________
Intake year__________
Compliance Information
1. Have you given any bribes or received any bribes before? Yes No
If yes, describe incidence:
_____________________________________________
Relationship Declaration
A) Questionnaire
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B) Individuals related to the state authorities or government officials
are:
People related to the state authorities of government officials could be as
follows:
Sports Organizations
Police, Fire Emergency, Medical Organizations
Municipal State Government (State Transport Services etc.)
International Social Organizations (National Unions, International Banks
etc.)
Diplomatic organizations etc.
Personal Referees
1. I hereby declare that I have never been convicted of any criminal or social
offence in court of law.
2. I understand that my training is subject to passing the medical examination by
the Company’s physician.
3. I understand that if at any time after engagement it is found that a false
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declaration has been made in this form or in my pre-training medical
examination, the company shall have the right to terminate my training
forthwith, without any further claims by me.
4. In accepting training with the company, I agree to abide by all the Standing
Rules and Regulations of the Company governing the conditions of work and the
conduct of its employees.
5. I hereby declare that the information submitted in this form is in every respect
true and complete.
6. I authorise the Employer to submit the said information to any person, firm,
corporation, body, bureau, department, police officials and Police Record
Bureau for the purpose of any investigation which the Employer may desire to
make with reference thereto. I also indemnify the Employer from all liabilities,
demands, claims, suits, proceedings, costs and expenses of any nature in
connection with the foregoing.
________________ ___________________
Date of Application Signature of
Applicant
Remarks
____________________________
___________________
Signature/ Name
Date
The purposes for which your personal data may be used are, but not
limited to:-
("the Purposes")
If you fail to supply us with such personal data, we may not be able to
process and/or disclose your personal data for any of the above
Purposes.
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Any personal information retained by us shall be destroyed and/or
deleted in accordance with our retention policy applicable for us in the
event such information is no longer required for the said Purposes.
Consent
You may at any time after the submission of your personal data to us,
request us to update your personal data and/or limit your data
processing by directing it to our human resource department or at
[email protected].
__________________________________________
Applicant’s signature
__________________________________________
Applicant’s name
__________________________________________
Date
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