JOB APPLICATION FORM

PLEASE READ THESE INSTRUCTIONS CAREFULLY

1. This form is to be completed before the interview session.
(PLEASE ATTACH
2. Please use capital letters. A RECENT
3. Do not leave any item blank. If it is not applicable to you, please indicate “N.A.” PASSPORT SIZED
PHOTOGRAPH)
4. Please attach a copy of your IC or passport showing all relevant details.
5. Please attach photocopies of all your educational certificates & present the original
certificates during interview.

Position Applied For:

Name :
(Please
Please write your name in full as per your IC or passport)

Title : Mr/Encik Mrs/Puan Ms/Cik Others

Address :

Postcode: State :

House tel. : Office tel.:

Mobile number : E-mail :

Personal details

New NRIC : Race :

Religion : Age :

Passport no : Gender :

Nationality : Place of Birth :

Date of Birth : Marital Status :

Height (In Cm) : Weight (In Kg) :

Education details

YEAR ATTENDED QUALIFICATION

TYPE OF SCHOOL NAME OF SCHOOL LOCATION
FROM TO OBTAINED

SECONDARY

COLLEGE

UNIVERSITY

OTHERS
 JOB APPLICATION FORM

Please indicate competency in languages [B = basic I = intermediate F = fluent]

LANGUAGE / DIALECTS SPOKEN WRITTEN

Specify training courses (with dates)

TRAINING ATTENDED PROVIDER YEAR

Membership of organizations (Professional, social, sporting etc.)

ORGANIZATION YEAR

Employment History

Please indicate your employment history beginning with your current / most recent employer

Name of Company :

Type of Business/Industry :

Position Held : From : To : _

Current/Last Basic Salary : Fixed Allowances : 1.

Bonus: Contractual 2.

Performance 3.

Reason for leaving :

Name of Company :

Type of Business/Industry :

Position Held : From : To :

Reason for leaving :

Name of Company :

Type of Business/Industry :

Position Held : From : To :

Reason for leaving :

 Statutory Information

INCOME TAX: EPF: SOCSO:

Other Information

1. Do you have any past CRIMINAL RECORDS?

NO YES (If Yes, please give details)

2. Have you been charged with any criminal acts or have been subjected to any civil or criminal investigation in any
COURT OF LAW?
NO YES (If Yes, please give details)

3. If your answer to Question 2 is affirmative, have you been found guilty of any criminal or civil acts in any COURT OF
LAW? NO YES (If Yes, please give details)

4. If your answer to Question 3 above is affirmative, what is the PUNISHMENT/ORDER given by Court of any local
authority?

5. Have you been detained under any written laws?

NO YES (If Yes, please give details)

6. Have you ever been declared BANKRUPT or charged under BANKRUPTCY ACT?
NO YES (If Yes, please give details)

7. Do you have any known illnesses?

NO YES (If Yes, please give details)

8. Apart from your current employment, do you have any other occupation? (Eg. PART TIME JOB/ ONLINE
BUSINESS / VOLUNTEERISM)
NO YES (If Yes, please give the following details)

ORGANIZATION INVOLVEMENT

References

List two references below.

NAME EMAIL ADD AND TELEPHONE RELATIONSHIP

 Declaration

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING:

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission
may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school,
current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision.
I release such persons and organizations from any legal liability in making such statements.
I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen
as a condition of employment, if required.
I understand that the offer of employment is conditioned upon my successfully passing a complete pre-employment medical examination. I
consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am
applying.
I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT
EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE
EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE
AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH
AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I
UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE
TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.
I have read, understand, and by my signature consent to these statements.

If my Application for Employment is successful, I authorize you to contact my doctor for further details and confirmation of my
state of health.

Signed: ........................................................................................ Date: ..............................................

DATA PROTECTION
UNAUTHORISED USE OR DISCLOSURE: The Act gives you certain rights. Except to the extent we are required or
permitted by law, the information which you provide in this application form and any other information obtained or
provided during the course of your application (“the information”) will be used solely for the purpose of assessing
your application. If your application is unsuccessful or you choose not to accept any offer of employment we make,
the information will not be held for longer than is necessary, after which time it will be destroyed, although relevant
information will be retained in the longer term to facilitate our equal opportunity monitoring. If your application is
successful, the information will form part of your employment file and we will be entitled to process it for all purposes
in connection with your employment. So that we may use the information for the above purposes and on the above
terms, we are required under the Act to obtain your explicit consent. Accordingly, please sign the consent section
below.
CONSENT TO MY PERSONAL INFORMATION BEING USED FOR THE PURPOSE AND ON THE TERMS ABOVE

Signed: ......................................................................................... Date: ..............................................

Disclaimer: WiseManPower does not enter into correspondence with regard to the reasons for non – selection of candidate
HUMAN RESOURCE SERVICES

For Official Use Only: (To be filled by the Evaluator)

INDEX :
Name
Profile
Salary
Company
Country
Remarks
Evaluator
Signature