JIMAH ENERGY VENTURES SDN BHD / JIMAH O & M SDN BHD Private & Confidential

APPLICATION FOR EMPLOYMENT

Position Applied For :

PERSONAL PARTICULARS PHOTOGRAPH

Name of Applicant:
(as per Identity Card)

Permanent Address: Correspondence Address:

Office Tel. No:

Residence Tel. No:
Tel. No: Handphone No:

NRIC No. (New): NRIC No. (old):

Age: EPF No:

Date of Birth: SOCSO No:

Place of Birth: Income Tax No:

Race: Citizenship:

Religion: Height (in cm)

Gender: Weight (in kg):

DRIVING LICENCE

Licence No: Class:

Date Issued: Expiry Date:

QUALIFICATIONS (kindly attach copies of academic qualifications)

Name of College/University/Institution Qualification Acquired Year of Graduation Highest Qualification

Name & Address of School Date From Date To Qualification

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OTHER RELEVANT PARTICULARS

Typing (w.p.m) Shorthand (w.p.m)

Other Courses (i.e. Professional/ Technical/Accounting) :

Computer Knowledge:

PERSONAL REFERENCE
Names, addresses & occupation of 2 referees, other than relatives or employee of this company, who could give personal refernce.

Name: Name:

Address: Address:

Occupation : Occupation:
Tel. No: Years Known: Tel. No: Years Known:

FAMILY DETAILS (if married please provide particulars of spouse)

Marital Status: Married / Single / Divorces / Widower

Name of Spouse:

Date of Marriage: NRIC No:

Income Tax No: Occupation:

Name & Address of Employer:

Tel. No:

CHILDREN'S DETAIL
Name: Gender: Date of Birth:

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PARENTS & SIBLINGS DETAIL

Name of Father: Occupation: Age: Name of Employer:

Name of Mother: Occupation: Age: Name of Employer:

Name of Brother(s) & Sister(s): Occupation: Age: Name of Employer:

DETAILS OF COURSES BEING PURSUE AT PRESENT

Course: Institution Name: Date of Commencement / Expected Completion Date:

KNOWLEDGE OF LANGUAGES (Kindly indicate either Slight, Fair or Fluent)

Written: Spoken:

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OTHER CURRICULAR ACTIVITIES

Sports & Hobbies: Details of Club / Society Membership:

WORKING EXPERIENCE (Present Employer)

Name & Address of Employer: Position Held: Date Joined:

Monthly Income : Do you consent to this Company

making reference with your present
employer? (Yes / No)

Expected Salary: Reason for Leaving: Noticeof termination required

(Day/Week/Month)

* Kindly attach a copy of your latest salary slip.

PREVIOUS EMPLOYER (S)

Name & Address of Employer: Position Held: Date Joined / Date Left: Reasons for Leaving:

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PERSONS TO BE NOTIFIED IN CASE OF EMERGENCIES

Name: Address: Relationship:

Contact No.:

LIST OF NAMES OF RELATIVES / FRIENDS EMPLOYED IN THIS COMPANY OR ITS SUBSIDIARIES (IF ANY)

Name: Relationship: Year(s) Known:

If currently working, please give a brief description of present work and responsibilities:

Please give a brief summary on how you see yourself in the working enironment in five years time:

DECLARATION OF CANDIDATE

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I hereby declare that all particulars given here are true and correct. I understand that if any of the
particulars are false, the Company reserves the right to take disciplinary action against me, including
terminating my services on immediate notice.

Date: Signature of Applicant:

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