EMPLOYMENT APPLICATION FORM
PHOTO
Position Applied For: ______________________________________
APPLICANTS PERSONAL DETAILS
Full Name (As in your ktp) :
Ktp No. :
Date of Birth: Place Of Birth: Age:
Marital Status: Race: Religion:
Home Address:
Contact No: Office:
EDUCATION BACKGROUND (Please attach copies of certificates)
Name of School / College / University YEAR Qualification Attained
From To
EMPLOYMENT HISTORY(Please begin with the current employment)
Name of company Period Reason For Briefly describe your duties Last Drawn
Leaving and responsibility’s Salary
EXPECTED SALARY AND OTHER DETAILS
Earliest Available Start Date : Expected Salary:
REFERENCES (Please provide at least two references, Family members are not to be included)
Name Relationship Years Known Contact No.
DECLARATION:
1. Have you ever been convicted for any criminal offences or in any criminal proceeding’s? *Yes/No
If yes, please furnish details of offences.
_________________________________________________________________________
_________________________________________________________________________
2. Have you ever been dismissed or suspended from any employment? *Yes/No
If yes, please furnish reasons.
_________________________________________________________________________
_________________________________________________________________________
I hereby declare that all information contained in this form is correct and true to the best of my knowledge I hereby
allow and authorize the employer to investigate independently of all statements contained in this application prior
to my employment. I also hereby give the employer the permission to contact references to conduct checks hereby
release the employ form any liability as a result of such contact. Any material misrepresentation or omission of
information shall be grounded for the employer decision to reject my application or, it will be sufficient ground for
immediate dismissal without notice or payment in lieu of notice in the event that I am hired by the employer.
_____________________ _______________________ ______/_______/________
Applicant Name Signature Of Applicant Date
For Office Use Only
• Short-listed /Rejected /Employed:
• Commencement Date:
• Interview By/Date:
• Approved By/ Date:
• Salary:
• Remarks (If any):
