UNIVERSITI BRUNEI DARUSSALAM

Post and Area of Specialisation applied for:

Reference number:
Date of any previous application:
Please indicate the source from where you
obtained information regarding the vacant
post at Universiti Brunei Darussalam:

PERSONAL PARTICULARS
Full Name (with qualifications in brief):

Date of Birth:

Place of Birth:

Nationality:

Citizenship:

Marital Status:

Religion:

Sex:

Country of Domicile:

Passport No.:

Expiry Date:

Address of
correspondence:
Telephone [Office]:

E-Mail:

Telephone [Home]:

Fax No.:

Present Post:
Basic Salary (US$):
Other Emoluments and Allowance (US$):
Period of Notice before Reporting for Duty in Brunei:

Income tax deduction (%)

Attach
passport-size
photograph
here

ACADEMIC RECORD with dates

Universities or Higher Education
Institutions Attended:
Post School Qualifications: (with institutions attended, dates and brief details of subjects, grades and qualifications)

Fellowship and Membership of Learned and Professional Societies:

EMPLOYMENT RECORD CURRENT POST

Institution:

Faculty/School/Department:

Duties:

Current Position of Responsibility

[e.g. Head of Department]:
Previous Posts and Responsibilities in this Institution:

PREVIOUS EMPLOYMENT [in chronological with dates]

Names and Dates of Previous Institutions/Employers with brief details of posts and responsibilities.
In Higher Education:
Positions held

Name of Institution

Date (From To)

Nature of Employment

Name of Institution

Date (From To)

Nature of Employment

Other Employers:
Positions held

TEACHING AND SUPERVISION

Indicate Courses which you can Teach and Others which you are Willing to Offer at undergraduate and
postgraduate levels:

Supervision Experience: Please indicate and provide list of supervision at undergraduate level (such as final year
projects) and postgraduate level (Masters degree and PhD students)
[Use additional sheet if necessary]

RESEARCH AND PUBLICATIONS

Indicate Present Research and Areas of Interest. Please attach list of Publications (Books and Monograph,
International Journals, Other Scholarly Publications) and patents in chronological order.

[Use additional sheet if necessary]

No of citations
Google Scholar
Date (as of)

H Index

SCOPUS
Date (as of)

No of citations

H Index

LANGUAGES
Fluent

Written Ability
Good

Fair

Fluent

Spoken Ability
Good

Fair

Malay
English
Arabic
Others:

HOBBIES AND INTERESTS:

FAMILY PARTICULARS
Children Name

Date of Birth

Sex

1.
2.
3.
4.
Applicants Spouse [Indicate briefly, if you wish your spouses occupation and qualifications and possible
employment interest in Brunei [this does not imply that any such employment is available].
Full Name :

REFEREES
Give details of three referees [including position and qualifications], stating whether they may be contacted at this
stage. Please include telephone, fax numbers and email address. Please include your present immediate supervisor
or Head of Department as ONE of your referees.
1.
2.
3.
I declare that the particulars in this application and the attached sheets hereto are true to the best of my knowledge
and belief, and that I have not wilfully withheld any material fact.
Signature :

Date:

Notes
(1) A letter of application and any further details may be attached.
(2) Attach a recent photograph to each copy of this application form.