Ct-Hr-01-Employment Application Form - CT

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EMPLOYMENT APPLICATION FORM

PRIVATE & CONFIDENTIAL

Position Applied: __________________________________________________________

1. PERSONAL INFORMATION

FULL NAME: _______________________________________________________


NRIC/PASSPORT NO: _________________________________________________
D.O.B: ____/____/_______
ADDRESS: _________________________________________________________
__________________________________________________________________

NATIONALITY: ______________________

CONTACT NO: _______-__________________

RACE: ________________________ RELIGION: ________________________

EPF NO: ______________________ SOCSO NO: ________________________

INCOME TAX NO: _________________________

2. FAMILY INFORMATION

NAME RELATIONSHIP OCCUPATION


3. MARITAL STATUS
(Please tick Yes/No)

YES NO

SINGLE
MARRIED
DIVORCED
SINGLE PARENT
ARE YOU PREGNANT?

NO. OF CHILDREN: ______

PARTICULARS OF CHILDREN:

NAME AGE

4. HEALTH

Do you have any health issues? YES / NO


If YES, please state:
______________________________________________________________________
______________________________________________________________________

Are you currently under any medication? YES / NO


If YES, please state:
______________________________________________________________________
______________________________________________________________________
5. EDUCATION

EDUCATION NAME OF INSTITUTION COURSE NAME YEAR


LEVEL COMPLETED

6. OTHER TRAINING

COURSE INSTITUTION QUALIFICATIONS YEAR

7. LANGUAGES
(Please tick for Slight / Fair / Fluent)

LANGUAGE SPEAKING READING WRITING


8. EMPLOYMENT HISTORY
(Current/Most recent employer first)

Company:
Position: From: To:
Basic: Allowance:
Type of
Commission: Allowance:
Bonus:
Other Incentives:
Reason for Leaving: _____________________________________________________________

Company:
Position: From: To:
Last
Remuneration:
Reason For Leaving:
______________________________________________________________________________

Company:
Position: From: To:
Last
Remuneration:
Reason For Leaving:
______________________________________________________________________________

Company:
Position: From: To:
Last
Remuneration:
Reason For Leaving:
______________________________________________________________________________
9. REFERRALS

(Those acquainted with your work are preferred eg. present & past & immediate superiors)

NAME ADDRESS CONTACT NO DESIGNATION PLACE OF WORK

1.

2.

3.

Have you ever been convicted of a criminal offence?

YES / NO

If YES (state nature)

_______________________________________________________________________________

_______________________________________________________________________________

Remuneration expected: ______________________

Earliest available date: ________________________

I declare that the information provided above is true and complete in all aspects. I understand
that any misrepresentation or omission of information may be considered sufficient for
withdrawal of an offer or subsequent dismissal from employment.

______________________

Signature

Date: _________________

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