Employment Application

‫ﻧﻤﻮذج ﻃﻠﺐ ﺗﻮﻇﻴﻒ‬

‫اﻻﺳﻢ ﺑﺎﻟﻜﺎﻣﻞ‬
Full Name
: ‫ﻣﻜﺎن اﻟﻤﻴﻼد‬ ‫اﻟﺠﻨﺴﻴﺔ‬

‫ﺻﻮرة‬ Place of Birth Nationality

‫ﻓﺼﻴﻠﺔ اﻟﺪم‬ ‫اﻟﻤﻬﻨﺔ‬
Photo Job Applied For
Blood Type
× : ‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬ : ‫اﻟﺪﻳﺎﻧﺔ‬
Date of Birth Religion
‫اﻟﺮﻗﻢ اﻟﻮﻇﻴﻔﻲ‬ : ‫ﺗﺎرﻳﺦ اﻹﺻﺪار‬ ‫رﻗﻢ اﻟــﻬـﻮﻳـﺔ‬
Employee ID Date of Issue I.D. Number
: ‫ﺗﺎرﻳﺦ اﻹﻧﺘﻬﺎء‬ : ‫ﻣﻜﺎن اﻹﺻﺪار‬
Expiry Date Place of Issue
‫ﻳﻌﺒﺄ ﻣﻦ ﻗﺒﻞ اﻻدارة‬ : ‫رﻗﻢ اﻟﺘﺄﻣﻴﻨﺎت اﻹﺟﺘﻤﺎﻋﻴﺔ‬
Fill by administration Gosi No.
‫اﻟﻤﻬﻨﺔ اﻟﻤﺴﺠﻠﺔ ﻓﻲ اﻟﻬﻮﻳﺔ اﻟﻮﻃﻨﻴﺔ‬ ‫ﻧﻌﻢ‬ ‫ﻻ‬ ‫ﻫﻞ وﻇﻴﻔﺘﻚ اﻟﺴﺎﺑﻘﺔ ﺣﻜﻮﻣﻴﺔ ؟‬

‫اﻟﺤﺎﻟﺔ اﻹﺟﺘﻤﺎﻋﻴﺔ‬
‫أﻋـﺰب‬ ‫ﻣﺘﺰوج‬
Family Status
Single Married
‫ ﻳﺮﺟﻰ إرﻓﺎق ﻧﺴﺨﺔ‬،‫ﻧﻌﻢ إذا ﻛﺎﻧﺖ اﻹﺟﺎﺑﺔ ﻧﻌﻢ‬ ‫ﻧﻌﻢ‬ ‫ﻻ‬ ‫رﺧــﺼﺔ اﻹﻗــﺎﻣﺔ ﻋﺎﺋﻠﺔ‬
(If Yes, Please Attach a copy) YES Family Residence Permit
NO

‫ﻫﻞ ﺗﻌﻤﻞ ﺣﺎﻟﻴ ًﺎ ؟‬ : ‫ﻋﺪد أﻓﺮاد اﻷﺳﺮة‬ ‫أﺳﺮﺗﻚ ﻫﻞ ﺗﻘﻴﻢ ﻣﻌﻚ ﺑﺎﻟﻤﻤﻠﻜﺔ ؟‬
Are you currently working? Number of Family Is Your Family Residing In KSA?
Members
. ‫ﻫﻞ ﺗﺸﻜﻮ ﻣﻦ أي ﻣﺸﻜﻠﺔ ﺻﺤﻴﺔ أو إﻋﺎﻗﺔ أو أﻣﺮاض ﻣﺰﻣﻨﺔ ؟ اﻟﺮﺟﺎء اﻟﺘﻮﺿﻴﺢ‬
Have you suffered from any chronicle disease or physical disability? Please Describe

: ‫اﻟﻌﻨﻮان اﻟﺪاﺋﻢ داﺧﻞ اﻟﻤﻤﻠﻜﺔ‬

Permanent Address in K.S.A
‫ب‬.‫ص‬
‫اﻟﻤﺪﻳﻨﺔ‬
P.O. Box
City
‫ﻫﺎﺗﻒ‬ ‫ﺟﻮال‬
Tel Mobile
: ‫اﻟﺒﺮﻳﺪ اﻟﻸﻟﻜﺘﺮوﻧﻲ‬
E-mail Address
‫ﻫﻞ ﻟﺪﻳﻚ رﺧﺼﺔ ﻗﻴﺎدة ؟‬
Do you have a valid Driving License?
‫ﻧﻌﻢ‬ ‫ﻻ‬
YES NO ‫ﻫﻞ ﺗﻤﺘﻠﻚ ﺳﻴﺎرة ؟‬ ‫ﺻﺎﻟﺤﺔ ﺣﺘﻰ‬ ‫ﻧﻘﻞ ﺛﻘﻴﻞ‬ ‫ﻧﻘﻞ ﺧﻔﻴﻒ‬ ‫ﺧﺼﻮﺻﻲ‬ : ‫ﻧﻮﻋﻬﺎ‬
Do you own a private Valid Until Transfer Heavy Transfer light Private Type
Car?

: ( ‫ﻟﻐﻴﺮ اﻟﺴﻌﻮدﻳﻴﻦ ) ﻓﻘﻂ‬

For NON-Saudis (only)

: ‫اﺳﻢ ﻛﻔﻴﻠﻚ اﻟﺤﺎﻟﻲ‬ : ‫إﻣﻜﺎﻧﻴﺔ اﻟﺘﻨﺎزل ﻋﻦ اﻟﻜﻔﺎﻟﺔ‬

Name of Current Sponsor Is Your Iqama Transferable?
: ‫اﻟﻌﻨﻮان ﻓﻲ اﻟﺒﻠﺪ اﻷم‬
Address in Home Country
‫ﺟﻮال‬ : ‫ﻫﺎﺗﻒ‬ ‫ب‬.‫ص‬ : ‫اﻟﻤﺪﻳﻨﺔ‬ : ‫اﺳﻢ اﻟﺒﻠﺪ‬
Mobile Tel P.O. Box City Country
 Employment Application

‫ﻧﻤﻮذج ﻃﻠﺐ ﺗﻮﻇﻴﻒ‬

: ‫اﻟﻤﺆﻫﻼت اﻟﻌﻠﻤﻴﺔ‬
Qualifications
‫اﺳﻢ اﻟﺸﻬﺎدة واﻟﺘﺨﺼﺺ‬ ‫ﺗﺎرﻳﺦ اﻟﺘﺨﺮج‬ ‫اﻟﺒﻠﺪ‬ ‫اﺳﻢ اﻟﻤﺪرﺳﺔ أو اﻟﺠﺎﻣﻌﺔ‬
Major /Field of study Date of Graduation Country Name of School or University

‫اﻟﺨﺒﺮات اﻟﻌﻤﻠﻴﺔ‬
Experiences

‫اﻟﻔﺘﺮة‬
‫أﺳﺒﺎب ﺗﺮك اﻟﺨﺪﻣﺔ‬ ‫اﻟﺮاﺗﺐ‬ ‫ﻣﺴﻤﻰ اﻟﻮﻇﻴﻔﺔ‬ Time ‫اﺳﻢ اﻟﺠﻬﺔ‬
Title No
Reasons for Leaving Salary ‫إﻟﻰ‬ ‫ﻣﻦ‬ Employers Name
To From

‫ﺿﻊ ﻋﻼﻣﺔ ) √ ( ﻓﻲ اﻟﻤﻜﺎن اﻟﻤﻨﺎﺳﺐ‬

Mark (√ ) where applicable
‫اﻟﺘﺤﺪث‬ ‫اﻟﻘﺮاءة‬ ‫اﻟﻜﺘﺎﺑﺔ‬
Speaking Reading Writing
Language
‫ﺿﻌﻴﻒ‬ ‫ﺟﻴﺪ‬ ‫ﻣﻤﺘﺎز‬ ‫ﺿﻌﻴﻒ‬ ‫ﺟﻴﺪ‬ ‫ﻣﻤﺘﺎز‬ ‫ﺿﻌﻴﻒ‬ ‫ﺟﻴﺪ‬ ‫ﻣﻤﺘﺎز‬
Weak Good Excellent Weak Good Excellent Weak Good Excellent

‫اﻟﻌﺮﺑﻴﺔ‬
Arabic

‫اﻹﻧﺠﻠﻴﺰﻳﺔ‬
English

‫أﺧﺮى‬
Others
 Employment Application

‫ﻧﻤﻮذج ﻃﻠﺐ ﺗﻮﻇﻴﻒ‬

‫ﻻ‬ ‫ﻧﻌﻢ‬
‫ﻫﻞ ﺳﺒﻖ ﻟﻚ اﻟﻌﻤﻞ ﻓﻲ ﺷﺮﻛﺔ ﻋﺒﺪاﻟﻘﺎدر وأوﻻده أو اﺣﺪى ﺷﺮﻛﺎت اﻟﻤﻬﻴﺪب‬
NO YES
Have you work in Al Muhaidib(AKM)or any of its subsidiaries?

‫اذا ﻛﺎﻧﺖ اﻻﺟﺎﺑﺔ )ﻧﻌﻢ( اذﻛﺮ اﺳﻢ اﻟﺸﺮﻛﺔ‬

If yes, please provide the company’s name
‫ﻫﻞ ﻟﻚ أﻗﺎرب ﻳﻌﻤﻠﻮن ﻓﻲ ﺷﺮﻛﺔ ﻋﺒﺪاﻟﻘﺎدر اﻟﻤﻬﻴﺪب أو اﺣﺪى ﺷﺮﻛﺎت اﻟﻤﻬﻴﺪب‬
Do you have any relative currently employed by AKM?

‫ ﺻﻠﺔ اﻟﻘﺮاﺑﺔ‬، ‫ واﻟﻤﻨﺼﺐ‬، ‫اﻟﺸﺮﻛﺔ‬

Company, Position,
Type of relation

‫أﻛﺘﺐ ﺑﺈﻳﺠﺎز ﻋﻦ اﻷﺳﺒﺎب اﻟﺘﻲ دﻓﻌﺘﻚ ﻟﺘﻘﺪﻳﻢ ﻫﺬا اﻟﻄﻠﺐ‬

Briefly write-down the reasons for submitting this job application

2) 1)

4) 3)

‫ﻣـــﻬـــﺎراﺗــﻚ‬
Skills

( ‫أذﻛﺮ اﺳﻢ ﺷﺨﺼﻴﻦ ﻳﻤﻜﻦ اﻹﺗﺼﺎل ﺑﻬﻢ ﻓﻲ ﺣﺎﻟﺔ ﺣﺪوث اﻣﺮ ﻃﺎرئ ﻟﻚ ) ﻻﺳﻤﺢ اﻟﻠﻪ‬
Name two contact persons for in case of an emergency

‫ﺟﻮال‬ ‫اﻹﺳﻢ‬
‫ﻫﺎﺗﻒ‬
Mobile Name
Tel.
‫اﻟﻌﻨﻮان‬
Address
‫ﻫﺎﺗﻒ‬
: ‫ﺟﻮال‬ : ‫اﻹﺳﻢ‬
Tel. Name
Mobile
‫اﻟﻌﻨﻮان‬
Address

‫اﻟﺮاﺗﺐ اﻟﺸﻬﺮي اﻟﻤﺘﻮﻗﻊ ﻟﺤﺰﻣﺔ ﻛﺎﻣﻠﺔ؟‬

‫ﻣﺎ ﻫﻮ اﻟﻤﺒﻠﻎ اﻟﺬي ﺗﺘﻮﻗﻌﻪ ﻛﺮاﺗﺐ ﺷﻬﺮي ؟‬
Expected full package monthly salary?
Expected basic monthly salary?

Provide the following items to complete request ‫ﻳﺮﺟﻰ ﺗﻮﻓﻴﺮ اﻟﻤﺘﻄﻠﺒﺎت اﻟﺘﺎﻟﻴﺔ ﻹﺳﺘﻜﻤﺎل ﻃﻠﺐ اﻟﺘﻮﻇﻴﻒ‬
.‫ اﻟﻌﺎﺋﻠﺔ‬/‫ﻹﻗــﺎﻣﺔ‬/‫ﺻﻮرة واﺿﺤﺔ ﻣﻦ اﻟﻬﻮﻳﺔ‬
1. Clear Copy of your ID/Iqama/ Family.
2. Copy of all certificates and reference. ‫ﺻﻮرة ﻣﻦ اﻟﺸﻬﺎدات اﻟﻌﻠﻤﻴﺔ واﻟﺨﺒﺮة‬
3. Copy of your driving license.
‫ﺻﻮرة رﺧﺼﺔ اﻟﻘﻴﺎدة‬
4. “Clearance Letter” from your former employer
5. IBAN ‫اﺧﻼء ﻃﺮف ﻟﻤﻦ ﺳﺒﻖ ﻟﻪ اﻟﻌﻤﻞ‬
6. GOSI
‫اﻟﺤﺴﺎب اﻟﺒﻨﻜﻲ اﻟﺪوﻟﻲ‬

‫اﻟﺘﺄﻣﻴﻨﺎت اﻻﺟﺘﻤﺎﻋﻴﺔ‬
 Employment Application

‫ﻧﻤﻮذج ﻃﻠﺐ ﺗﻮﻇﻴﻒ‬

ً
‫ ﻛﻤﺎ‬.‫ﻣﻨﺎﺳﺒﺎ‬ ‫ وﻟﻠﺸﺮﻛﺔ اﻟﺤﻖ ﺑﺎﺗﺨﺎذ اﻹﺟﺮاء اﻟﺬي ﺗﺮاه‬،‫ وأﺗﺤﻤﻞ ﻛﺎﻣﻞ اﻟﻤﺴﺆوﻟﻴﺔ ﺣﺎل اﻛﺘﺸﺎف ﺧﻼف ذﻟﻚ‬،‫أﺗﻌﻬﺪ أﻧﺎ اﻟﻤﻮﻗﻊ أدﻧﺎه ﺑﺄن ﺟﻤﻴﻊ اﻟﺒﻴﺎﻧﺎت اﻟﻤﺬﻛﻮرة أﻋﻼه ﺻﺤﻴﺤﺔ‬

ً
.‫ﺧﻄﻴﺎ ﺑﺬﻟﻚ‬ ‫ وﻓﻲ ﺣﺎﻟﺔ ﺗﻐﻴﻴﺮه ﻓﺴﻮف أﺑﻠﻎ اﻟﺸﺮﻛﺔ‬،‫أؤﻛﺪ ﺑﺄن ﻋﻨﻮاﻧﻲ اﻟﺤﺎﻟﻲ ﻫﻮ اﻟﻤﺬﻛﻮر أدﻧﺎه‬
I, the undersigned confirm that all stated information above are true, and I’m fully aware that if it is found-out otherwise, the company shall
take it’s deemed proper action. Furthermore, I confirm my current address stated below, and obliged to post the company – in writing - if any
change occurred.
: ‫ﺗﻮﻗﻴﻊ ﻣﻘﺪم اﻟﻄﻠﺐ‬
Applicant's Signature:

(‫ﻹﺳﺘﻌﻤﺎل داﺧﻞ اﻟﺸﺮﻛﺔ ) ﻓﻘﻂ‬

For company use (Only)

: ‫ﺳﻌﺎدة اﻟﻤﺪﻳﺮ اﻟﻌﺎم ﺗﻢ إﺟﺮاء اﻟﻤﻘﺎﺑﻠﺔ ﻣﻊ اﻟﻤﺬﻛﻮر وﻛﺎﻧﺖ اﻟﻨﺘﻴﺠﺔ‬

To General Manager Result of the interview with the above mentioned Is

‫وﻧــــــﻮﺻـــﻲ ﺑـﺘﻌﻴﻴﻦ اﻟﻤﺬﻛﻮر ﺑﻤﻬﻨﺔ‬

..............................We
................................. ...........................
recommend above is being appointed
‫اﻟﻔﺮع‬
‫ﻗــﺴﻢ‬
Branch
Section
‫اﻟـــﺒـﺪﻻت‬ ‫اﻟﺮاﺗﺐ اﻷﺳﺎﺳﻲ‬
Allowances Basic Salary

: ‫اﻟﺘﺎرﻳﺦ ﻣﺒﺎﺷﺮة اﻟﻌﻤﻞ‬

Date of performing duties

: ‫ﺗﻮﻗﻴﻊ ﻣﺪﻳﺮ اﻻداره‬

Dept. Manager Sing.

‫اﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ‬
Human Resources

‫اﻟـــــــــــﺘــــﻮﺻــﻴــﺎت‬
Recommendations

‫ﺗﻮﻗﻴﻊ ﻣﺪﻳﺮ اﻟﻤﻮارد اﻟﺒﺸﺮﻳﺔ‬

H. R. Manager Signature

‫اﻟﻘﺮار اﻟﻨﻬﺎﺋﻲ‬
Final Decision
‫ﻏﻴﺮ ﻣﻘﺒﻮل‬ ‫ﻣﻘـﺒﻮل‬
Rejected Accepted

‫ﺗﻮﻗﻴﻊ اﻟﻤﺪﻳﺮ اﻟﻌﺎم‬

G. M. Signature