PRIVATE CONFIDENTIAL (SULIT)

FORM HR-1 Page 1 of 4

UNITED MALACCA BERHAD

(1319-V)

EMPLOYMENT APPLICATION (BORANG PERMOHONAN)

POSITION APPLIED FOR: JAWATAN YANG DIPOHON:

RECENT PASSPORT-SIZE PHOTOGRAPH TO BE ATTACHED HERE

This form should be completed in BLOCK LETTERS 1. PERSONAL PARTICULARS (DATA PERIBADI) : Name (as per I/C) : Mr/Mrs/Ms/Others: ____ Nama: Current Correspondence Address: Alamat Terkini:

Permanent Address: Alamat Tetap:

Telephone No: Nombor Telefon:

Date of Birth: Tarikh Lahir: Race: Bangsa: Nationality : Kewarganegaraan:

Place of Birth: Tempat Lahir: Religion: Agama:

Age: Umur: NRIC/Passport No. (New/Baru ): No IC/Passport (Old/Lama ): Have Own Transport: Memiliki Kenderaan: Name of Spouse: Nama Suami/Isteri:

Sex : Jantina:

Type: Jenis: Nationality: Kewarganegaraan:

Marital Status: Single/Married/Widow/Widower/Divorcee (Bujang/Kahwin/Balu/Duda/Janda)

Occupation of Spouse: Pekerjaan Suami/Isteri: 2. FAMILY DETAILS (DATA PERIBADI KELUARGA ) Name Nama Relationship Hubungan Age Sex Umur Jantina Date of Birth Tarikh Lahir Occupation Pekerjaan Name of School/Company Nama Sekolah/Syarikat

FORM HR-1 Page 2 of 4 3. EDUCATION (PENDIDIKAN) Type of School Jenis Sekolah (Primary/Secondary/Tertiary) Name & Location of School Nama & Tempat Sekolah Year/Tahun From To Dari Ke Qualification(s) Kelayakan Grade Keputusan

4. PROFICIENCY IN LANGUAGES (KECEKAPAN DALAM BAHASA) Please tick ( ) at the appropriate column Languages/Dialects Speak / Pertuturan Write / Penulisan English/Bahasa Malaysia/Chinese Good Fair Poor Good Fair Poor English Bahasa Malaysia Mandarin Dialect (Indicate:______________) 5. SPECIAL TRAINING/PROFESSIONAL CERTIFICATES LATIHAN KHAS Date Obtained Tarikh

Remarks

6. PREVIOUS & PRESENT EMPLOYMENT (PEKERJAAN DAHULU & SEKARANG) List most recent job first. Senaraikan pekerjaan yang terkini dahulu i ) Name of Company: Nama Syarikat: Designation: Jawatan: From: Dari: To: Ke: Last Drawn Salary: Gaji Terakhir: Type of Business: Jenis Perniagaan: Telephone No.: Nombor Telefon:

Allowances / Benefits (if any): Elaun / Faedah (kalau ada): Reason for Leaving: Sebab Berhenti: ii ) Name of Company: Nama Syarikat: Designation: Jawatan: From: Dari: To: Ke: Last Drawn Salary: Gaji Terakhir: Type of Business: Jenis Perniagaan: Telephone No.: Nombor Telefon:

Allowances / Benefits (if any): Elaun / Faedah (kalau ada): Reason for Leaving: Sebab Berhenti:

FORM HR-1 Page 3 of 4 7. HOBBIES & INTERESTS (KEGEMARAN & MINAT)

(which you may consider may support your application further eg. courses/training attended, professional/social achievements, in clubs, welfare work, etc.) (yang mana tuan/puan menganggap akan tambah menyokong permohonan seperti kursus/latihan yang dihadiri, kecapaian profesional/sosial di dalam kelab-kelab, kerja kebajikan dan lain-lain)

8. EXPECTED SALARY GAJI YANG DIPOHON 9. REFEREES (RUJUKAN ) Name Nama Address Alamat Occupation Pekerjaan Period Known Tempoh Berkenalan Telefon No. Nombor Telefon

10. OTHER INFORMATION (MAKLUMAT LAIN )

( i ) Are you willing to serve anywhere in Malaysia? If not, where are you willing to work? Adakah anda bersedia untuk berkhidmat di mana-mana di Malaysia? Kalau tidak, di tempat mana yang tuan/puan ingin berkhidmat?

( ii ) Have you been, or are you, suffering from any physical impairment or disease? Adakah tuan/puan telahpun atau sedang mengidap apa-apa kelemahan jasmani atau penyakit? YES / NO YA / TIDAK If Yes, type of illness/impairment : Kalau YA, sila nyata jenis penyakit atau kelemahan How long / Berapa Lama :

( iii ) Have your ever been convicted for a criminal offence in a Court of Law in any Country?: YES / NO Adakah tuan/puan telah dihukum atas kesalahan jenayah didalam Mahkamah Undang di mana-mana negara? YA / TIDAK ( iv ) When would you be able to commence employment?: Bilakah tuan/puan boleh menyertai pekerjaan kami? Notice period : Masa Notis:

11. IN CASE OF EMERGENCY TO NOTIFY (JIKA ADA KECEMASAN SILA BERHUBUNG DENGAN)
Name (Nama) : Address (Alamat) : Relationship (Hubungan) : Telephone No. (Nombor Telefon) :

12. DECLARATION (PENGAKUAN)

I hereby declare that the information give by me in this Application Form is correct and true to the best of my knowledge. I fully understand and accept that, if any time of engagement if it is found that a false declaration has been made on this form, the Company has the absolute right to terminate my employment forthwith withoput notice or compensation. Saya mengaku bahawa butir-butir yang diisi di dalam borang ini adalah benar. Saya sangat memahami dan menerima jika didapati bahawa pengakuan ini tidak benar, pihak Syarikat berhak memberhentikan pekerjaan saya dengan serta-merta tanpa notis atau ganti-rugi.

___________________________

_____________________

Signature of Applicant Tandatangan Pemohon

Date: Tarikh:

FORM HR-1 Page 4 of 4 FOR OFFICIAL USE ONLY Position advertised on : Interview Date : Interview Assessment Completed by :

______________________________ Interviewed By:

_________________________ Date:

Selected / Not Selected / Date of Commencement KIV

Position

Grade

Salary/Scale

Remarks: