Borang Permohonan Jawatan (Unisel) No. Isu 2

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UNISEL-PT03-HR-PS-PK01-BO02

Tarikh Kuatkuasa : 13 Disember 2021


No. Isu :2

GENERAL MANAGER
ADMIN & HUMAN RESOURCES DEPARTMENT
UNIVERSITI SELANGOR (UNISEL)
Kampus Bestari Jaya
Jalan Timur Tambahan
45600 Bestari Jaya
Selangor Darul Ehsan, Malaysia
Application for Employment

PHOTO
Post applied for : Please affix
Recent passport
Faculty/Department : Size photograph
Scan
Remuneration Expected : Picture/scenery
Not Allowed
*One form for one position only.

I PERSONAL DETAILS

Full Name (per IC)


*Mr/Mrs/Ms : Place of Birth :

Passport/NRIC No. : Date of Birth :

Address Permanent : Nationality :

Religion :
Tel No. Office : Home : H/P :

Age : Marital Status : Race :

Correspondence : E-Mail :

In Case of Emergency

Person to be contacted : Contact No :

Address :

Relationships :
UNISEL-PT03-HR-PS-PK01-BO02
Tarikh Kuatkuasa : 13 Disember 2021
No. Isu :2

II EDUCATION (Please attach all relevant certificates)

Year
Highest
Diploma/Degree/ End/Year
Name of school/College/University Field Standard
Master/Ph.D Of
(CGPA)
Graduation

Please delete whichever is not applicable

III EMPLOYMENT HISTORY (Please attach all relevant testimonials)

NAME OF COMPANY &


CONTACT NO Position Held From To Basic Salary Allowance
(Begin with Present Employer)

Job Responsibilities :
Reason for Leaving :

Job Responsibilities :
Reason for Leaving :

Job Responsibilities :
Reason for Leaving :

Have you worked in this Company before?


YES NO
If “Yes”, provide the following details :

Date joined : Position :

Department : Last Salary :

Have you been terminated/dismissed/suspended from the service of any employer?


YES NO
If yes, please give details :
UNISEL-PT03-HR-PS-PK01-BO02
Tarikh Kuatkuasa : 13 Disember 2021
No. Isu :2

IV PERSONAL REFERENCE

Name Contact No. Profession Years Known To You

V PROFESSIONAL EDUCATION

From To Institution Course Name

VI ACTIVITIES

1. Of what Associations/Societies were/are you a member?

In School/Institute/Elsewhere Position Held Approximate Dates

2. Present hobbies/Interest/Sports :

VII GENERAL

1. Languages/Dialects Written/Spoken?

2. Have you ever been convicted of criminals offence YES NO


If Yes, give details :

3. Do you have any relatives/friends in our organization? YES NO


If Yes, give details :

4. Are you drug depender? (i.e morphine, cannabis, ecstasy? YES NO


If Yes, give details :

5. Do you suffer any health problem? YES NO


If Yes, give details :
UNISEL-PT03-HR-PS-PK01-BO02
Tarikh Kuatkuasa : 13 Disember 2021
No. Isu :2

I declare that to be the best of my knowledge, the particulars provided are true and I hereby give my
consent to be University to check my employment records with my previous employers. I am aware that
any false or misleading statements made by me will be cause for dismissal of employed.

Signature of Applicant Date

FOR OFFICE USE

Result: Hired Reserves (KIV) Rejected

Human Resources Date

Date of Commencement : Starting Salary :

Date of Interview : Interviewer :

Department : Position :

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