Application Employment Form (Exempt)

In compliance to EICC Code of Conduct Standards under Non Discrimination, all

qualified applicants will receive equal consideration for employment without
regard to race, color, age, gender, sexual orientation, ethnicity, disability, Recent
Photograph
pregnancy, religion, political affiliation, union membership or marital status.

Instructions
1 One copy of your Identity Card, educational certificates and latest payslip must accompany the application. The originals
should NOT be forwarded but must be produced later if required.

2 False particulars or wilful suppression of material facts will render you liable to disqualification, or if appointed, to dismissal
and/or appropriate legal proceedings.

3 The Company does not enter into correspondence with regard to the reasons for selection and non-selection of
candidates.

Position Applied For

PERSONAL PARTICULARS
Name (as in NRIC): Chinese Characters:

Residential Address:

Correspondence Address:

Contact No. (Home): Contact No. (Office): Contact No. (H/P):

NRIC/ Passport No: Age: Date of Birth:

Place of Birth: Gender: Marital Status:

Nationality: Race: Religion:

EPF No: Income Tax No: Email Address:

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FAMILY DETAILS
NAME RELATIONSHIP AGE OCCUPATION EMPLOYER

IN THE EVENT OF EMERGENCY, THE FOLLOWING PERSON SHOULD BE CONTACTED :

NAME RELATIONSHIP
ADDRESS CONTACT NO.

ACADEMIC QUALIFICATIONS OBTAINED

(Please furnish with supporting documents)
DATE
SCHOOL / INSTITUTION FROM TO DURATION HIGHEST STANDARD ATTAINED
(mm/yy) (mm/yy)

CURRENT EDUCATION COURSE(S) BEING PURSUED AT PRESENT

COMPLETION STANDARD
NAME OF INSTITUTION NAME OF COURSE PURSUING
DATE ATTAINED

EMPLOYMENT HISTORY
(Please state in chronological order starting from current appointment first. If space is insufficient, please write on a
separate sheet and attach it to this application.)
EMPLOYER'S NAME: EMPLOYER'S ADDRESS:

JOB TITLE: DATE JOINED:

STARTING PAY: ENDING PAY:

SUPERVISOR'S NAME & TITLE: REASON(S) FOR LEAVING:

DESCRIBE YOUR DUTIES:

MY-UTM HRD F005 V5 Page 2 of 6

EMPLOYMENT HISTORY (continued)
EMPLOYER'S NAME: EMPLOYER'S ADDRESS:

JOB TITLE: DATE JOINED: DATE LEFT:

STARTING PAY: ENDING PAY:

SUPERVISOR'S NAME & TITLE : REASON(S) FOR LEAVING:

DESCRIBE YOUR DUTIES:

EMPLOYER'S NAME: EMPLOYER'S ADDRESS:

JOB TITLE: DATE JOINED: DATE LEFT:

STARTING PAY: ENDING PAY:

SUPERVISOR'S NAME & TITLE : REASON(S) FOR LEAVING:

DESCRIBE YOUR DUTIES:

EMPLOYER'S NAME: EMPLOYER'S ADDRESS:

JOB TITLE: DATE JOINED: DATE LEFT:

STARTING PAY: ENDING PAY:

SUPERVISOR'S NAME & TITLE : REASON(S) FOR LEAVING:

DESCRIBE YOUR DUTIES:

MY-UTM HRD F005 V5 Page 3 of 6

ADDITIONAL INFORMATION (Compulsory)
(I) What are your strengths & weaknesses? How can you take advantage of your strengths? Compensate for your weaknesses?

(II) What do you look for in a Company that you would like to work for?

(III) What do you expect from your employer?

INTEREST & HOBBIES

(Please state position held in Club, Society, etc. if any)

LANGUAGE AND DIALECTS

(Proficiency level: 0 - Poor, 10 - Excellent)
LANGUAGE / DIALECT SPOKEN WRITTEN

PERSONAL CHARACTER REFERENCES

(Give the names of 2 references. They should be responsible persons who know you either in private or in business
Names of relatives must not be used, nor the names of distinguished persons, unless they know you well.)

NAME OCCUPATION PERIOD KNOWN ADDRESS & CONTACT NUMBER

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OTHER INFORMATION
1. Do you possess any valid driving licence? Yes/No
If yes, please provide details:

2. Have you ever suffered from any physical impairment or disease? Yes/No
If yes, please provide details:

3. Have you ever been convicted in a court of law : Yes/No

If yes, please provide details:

4. Have you ever been declared bankrupt? Yes/No

If yes, please provide details:

5. Are you currently in debt? Yes/No

If yes, please provide details:

6. Have you ever been employed by Unisteel Technology (M) Sdn. Bhd.? Yes/No
If yes, please provide the name:

7. Do you know anybody in the Company? Yes/No

If yes, please provide details:

8. How did you come to know about this job vacancy?

Employment
Newspaper Friends Agency Others

If shortlised,
Date Available to Commence Work

Expected Basic Salary

Agreement/Declaration
I authorise Unisteel Technology (M) Sdn Bhd to obtain information of my past employment, my medical/health status,
and to make character references from my former employers and others. I release all concerned from all liabilities
or responsibilities in connection therewith. I certify that all information supplied by me in this application is true,
complete and correct. I am required to furnish any supporting documents upon request. In any circumstances
of wilful falsification or omission of essential information, this application shall constitute sufficient cause for
termination of any employment resulting therefrom.

Signature Date

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FOR INTERVIEWER(S) USE ONLY

A. GENERAL IMPRESSION

NA Excellent Very Good Good Average Poor

Dress Code

Punctuality

Maturity / Personality

Confidence

Verbal Skills

Written Skills

B. KNOWLEDGE / SKILLS

Knowledge and skills

candidate possesses:

Excellent Very Good Good Average Poor

Relevant knowledge and
skills

C. REMUNERATION PACKAGE
Present Expected
Basic Salary
Allowance
Commission
AWS
Bonus
Other allowances
Annual Salary

D. RESULT OF INTERVIEW

Suitable KIV Reject

Candidate is:

Designation:

Department: Job Grade:

Proposed Salary: Commencement Date:

Interviewer's Name: Signature & Date :

Interviewer's Name: Signature & Date :

Approved by: Approved by:

HR & Admin Manager General Manager

Approval for grade Assistant Manager and above:

Headquarter: Human Resource Headquarter: COO

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