APPLICATION FOR EMPLOYMENT

Strictly Private & Confidential

(All information on this application form will be treated with strictest confidence)

Please attach the following documents:

1. Resume
2. Photocopies of relevant certificates
3. Photocopies of last 2 months payslips
4. Photocopy of NRIC

Photograph

Position applied for:

How do you know of the job? (e.g. NST/STAR/JOS Homepage/JobsDB.com/Jobstreet.com/Recruitment Agency/Referral)

PERSONAL PARTICULARS
Name (according to IC):

Chinese Characters:

Other Name (Nickname, Christian Name etc)

Permanent Address:

Correspondence Address (if different from above):

Tel. No. (House):

Tel. No. (Office):

Tel. No. (Handphone):

Personal Email:

Date of Birth:

Place of Birth:

Race:

Nationality:

Religion:

Possess own car?

Yes / No

Marital Status:

No. of children:

Driving License?

B/D/E

Languages & Dialects (spoken)

Languages (written):

MEDICAL HISTORY
Have you ever suffered from any serious
illness or been involved in any serious
accidents?

If yes, please state when & give details of illness or accident:

Yes

No

Smoking?

Yes

No

State any physical disability:

Eye-sight with aid?

Yes

No

Date of last medical examination:

Josm/hr/ML (HR02)

Page 1

Date of last X-ray:

7/28/2015

ACADEMIC OR PROFESSIONAL QUALIFICATIONS

Year

Name of School / Education Institution

Are you currently pursuing any course

Yes

Qualification

If yes, please state the name of the course:

No

EMPLOYMENT HISTORY
Year (From / To)

Employer Name & Nature of Business

JOS MAL/HR/WW (HR02)

Page 2

Position Held & A Brief

Description of Responsibilities

Reason(s) for leaving

7/28/2015

PERSON TO CONTACT IN CASE OF EMERGENCY

Name:

Relationship:

Tel. No.:

Address:

Do you have friends or relatives in service with this

Company? If yes, please provide details.

Name:
Relationship:

Yes

Years known:

No
Occupation:

Is this job been referred to you by any of JOS Malaysia employee? If Yes, please provide the referrals name and position.

Have you had past legal convictions/offences/police records?

Yes

No

If yes, please provide details.

Have you been subject to disciplinary proceedings and/or dismissal for professional misconduct?

Yes

No

If yes, please provide details.

REFEREES
Please state 2 persons who can act as your referees and who are not your relatives:
Name:

Name:

Address:

Address:

Tel. No.:

Years known:

Tel. No.:

Occupation:

Years known:

Occupation:

GENERAL INFORMATION

DECLARATION
I hereby declare that all the above particulars and attached documents given by me are true and correct to the best
of my knowledge. I authorize verification of all statements and answers to questions herein contained if I am
considered for employment. I understand that any misrepresentation or omission of facts called for herein will be
sufficient cause for dismissal without compensation from the Companys service if I have been employed.

___________________________

_________________________________

Date

JOS MAL/HR/WW (HR02)

Signature of Applicant

Page 3

7/28/2015

JOS MAL/HR/WW (HR02)

Page 4

7/28/2015