CONFIDENTIAL

JOB APPLICATION FORM

Instructions to applicants:
Please read the following instructions before you fill in this form.
Photo
1. All information given by you in this application must be true. Giving false information will render your job
application invalid.

2. Applications that are not properly completed or illegible may be rejected.

3. Attach one copy each of all your supporting documents. Please do not forward the originals, as these will only
be required if you are subsequently called for an interview. If your original documents have been lost or
mislaid, please obtain authenticated duplicates or certified true copies from the issuing authorities.

4. If space is insufficient, please attach additional sheets. You need not attach a separate resume to this
application form.

5. *Please delete as appropriate.

Post applied for:

I. PERSONAL DETAILS

Full Name *Dr / Mr / Mrs / Ms / Mdm

(Underline Surname / Family Name) ______________________________________________________________________

Address (as stated in NRIC) _______________________________________ Gender *M / F

______________________________________________________________ Date of Birth

(DD/MM/YYYY) ______________________

Correspondence Address (if different from above) _____________________ Nationality ______________________

______________________________________________________________ NRIC No ______________________

(Pink/Blue)*
______________________________________________________________  Yes  No
Singapore PR
Tel No: (Home) ____________________ (Mobile) __________________ ______________________
PR Date Obtained
Email _________________________________________________________
Passport no. ______________________
(if non-citizen)

Marital Status *Single / Married / Widowed / Divored Place of Birth ______________________

Age of Youngest Child (if any) _____________________________________ Citizenship ______________________

Possess driving licence:  Yes (Class______)  No Religion ______________________

Work Pass currently Holding:  Work Permit  S-Pass  E-Pass Race ______________________
 Others ______________________________
Dialect ______________________

Emergency Contact Person ________________________________________ Highest Academic

Qualification ______________________
Relationship _______________________ Contact No _________________
Year Graducated ______________________

Earliest date of starting work if offered appointment ____________________ Expected Salary ______________________

Current Remuneration

Basic Salary: __________________ Overtime Pay:  Yes  No Commission:  Yes  No

Fixed Allowance (Type/Amt): _______________________________________ Annual Leave Entitlement: _______________

AWS: _______ mth(s) Bonus: _______ mth(s) Others: ____________________________________________________

Page 1 of 4
 CONFIDENTIAL

II. FAMILY PARTICULARS (Please include immediate family members, including married ones)

Full Name Relationship Age Employer Occupation

III. EDUCATION / AWARDS

Name of School / Institution From To Certificate Attained

(dd/mm/yy) (dd/mm/yy)

IV. EMPLOYMENT HISTORY

From To Name of Employer Designation Reason for Leaving Last Drawn

(mm/yy) (mm/yy) Salary

V. NATIONAL SERVICE (MALE APPLICANTS ONLY)

Date of Enlistment Operationally-Ready Date Rank Organisation: SAF/SPF/SCDF

VI. ACTIVITIES / HOBBIES

Co-Curricular Activities / Sports Level of Participation / Position Held From (date) To (date)

Page 2 of 4
 CONFIDENTIAL

VII. STAFF REFERRAL (If YOU WERE REFERRED BY CURRENT EMPLOYEE OF MYREPUBLIC)
Name Designation Dept Relationship Years Know

VIII. REFEREES (2 REFERENCES WHO ARE NOT YOUR FAMILY MEMBERS OR RELATIVES)
Name Designation & Company Name Relationship Contact No / Email
Tel/ Mobile:

Email:
Tel/ Mobile:

Email:

PLEASE ANSWER THE FOLLOWING QUESTIONS BY DELETING “YES” OR “NO” AS APPROPRIATE. FOR ANY “YES”
ANSWERS, PLEASE PROVIDE DOCUMENTARY EVIDENCE

1. Have you ever suffered, or are suffering from any medical condition, illness, disease, mental illness or physical *Yes/No
impairment?

2. Have you ever been convicted in a court of law in Singapore or in any other country (excluding parking offences)? *Yes/No

3. Have you been charged with any offence in a court of law in Singapore or in any other country for which the *Yes/No
outcome is pending (excluding parking offences)?

4. Have you been or are you under any financial embarrassment e.g. an undischarged bankrupt? *Yes/No

5. Have you ever broken any bond (e.g. bonds associated with scholarships or training awards)? *Yes/No

6. Did you ever leave an employer without serving out your period of moral obligatory service (e.g. resulting from *Yes/No
no-pay leave taken or training)?
*Yes/No
7. Do you have any relatives employed by MyRepublic?
*Yes/No
8. Have you ever submitted an application for employment with MyRepublic?
*Yes/No
9. Have you ever ask to come for an interview with MyRepublic and did not turn up?
*Yes/No
10. Have you ever been employed by MyRepublic?

If you have answered “Yes” to any of the above questions, please provide the details.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

DECLARATION

(1) I give my consent for MyRepublic Limited authorities to obtain and verify information from or with any source, as you deem appropriate
for the assessment of my application for employment.

(2) I declare that all information given by me in this application for employment and any sheets attached hereto are true to the best of my
knowledge and I have not wilfully suppressed any material fact. I accept that if any of the information given by me in this application is
in any way false or incorrect, my application may be rejected or any offer of employment may be withdrawn.

Signature of Applicant: ________________________________ Date: _______________________________

Page 3 of 4
 CONFIDENTIAL

FOR OFFICIAL USE ONLY

1st Interview

2nd Interview

This portion to be completed upon successful application

Employment Terms
Probation Period : _____ months
Starting Pay : _______________________
Term Notice : _____Days / _____ Days (Before/ After confirmation)
Transport allowance : _______________
Annual Leave : 1st yr_____days, 2nd & subsequent ____days
Other allowance : ___________________
Appointment : ______________
Commencement Date : _______________
Signature : ________________
Department : ______________________

Reporting Supervisor: ______________

Other instruction

Name card (from commencement) : [ ] immediate [ ] 7 days [ ] 14 days

Page 4 of 4