 DAYA CMT SDN. BHD.

(208646-U)
 DAYA FMM SDN. BHD. (418776-U)
(a wholly owned subsidiary of Daya Materials Berhad)
Plot 81, Lebuhraya Kampung Jawa
Bayan Lepas, 11900 Penang
Phone : +604 642 2280
Fax : +604 642 2499

Please complete form in own handwriting. Wherever necessary, use additional sheets of paper. Upon completion, please
read declaration and sign.
Please affix
POSITION APPLIED FOR
photograph

PERSONAL PARTICULARS
Name (as per IC): Alias (if any):

NRIC / Passport No: Date & Place of Issue:

Permanent Address (outstation address, if any): Correspondence Address:

Tel No: Mobile No: Email:

Date of Birth: Place of Birth: Sex:

Nationality: Race: Religion:

EPF No: SOCSO No: Income Tax No:

Hobbies / Interests:

KNOWLEDGE OF LANGUAGE / DIALECTS

SPOKEN Languages / Dialects Good Average Poor

WRITTEN Languages / Dialects Good Average Poor

Note: ‘Good’ means able to be used with confidence & accuracy in all aspects of work

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PERSONAL DETAILS

Height: Weight: Vision: Hearing:

List any serious illness(es), operation(s) or accident(s) that you may have had with approximate dates.

FOR FEMALE APPLICANTS ONLY

Kindly state whether you are presently pregnant? YES / NO

If yes, kindly state how many months. ________________________________________

FAMILY PARTICULARS
Marital Status: No of Children: Age(s):

Spouse’s Name (if married): Occupation:

Father’s Name: Occupation:

Mother’s Name: Occupation:

EDUCATIONAL RECORD
Years Attended Highest
Type of School Name Qualification
From To Obtained

Primary

Secondary

College / University

Professional Courses

EMERGENCY CONTACT
Name Relationship:

Address:

Tel No (Residence): Tel No (Office): Mobile No:

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EMPLOYMENT RECORD

Please give details of all positions held since completing your education. Start with your present job and work backwards.

Name & Address of Reason for leaving /

Employment Period Position Salary
Firm Wanting to leave

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

From First Drawn

To Last Drawn

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MISCELLANEOUS

(1) Date available to start your employment:

(2) Notice to be given to present employer:

(3) Salary expected:

(4) Have you ever applied for employment in any of the companies in The Daya Group before? YES / NO

If yes, which company and when?

(5) Do you have any friend(s) / relative(s) working in The Daya Group? YES / NO

If yes, please give name, designation & department.

(6) Have you ever been committed to a drug rehabilitation centre? YES / NO

If yes, please state when

Were you ever an undischarged bankrupt or do you have a bankruptcy order issued or
(7) YES / NO
pending?

If yes, please state when

PERSONAL REFERENCES

Do not list friends or relatives

Name: Occupation:

Address:

Tel No: Mobile No:

Name: Occupation:

Address:

Tel No: Mobile No:

Any further information that you may wish to give in support of your application

DECLARATION
I hereby declare that all particulars given in this application to be true & correct. This declaration shall if I am
employed, constitute an integral part of the contract of services between the company and myself. I agree that if the
declaration is found to be in any part false or incorrect, the company reserves the right to dismiss me instantly
without any compensation. I also hereby declare that I have not been convicted of any criminal offence nor of any
civil offence which could have included a jail sentence.

SIGNATURE: DATE:

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P07QR02-0901
 DAYA CMT SDN. BHD. (208646-U)
 DAYA FMM SDN. BHD. (418776-U)

EMPLOYMENT QUESTIONNAIRE
JOB APPLICANT’S NAME : ____________________________________________

POSITION APPLIED FOR : ____________________________________________

1. Why did you apply for this job?

2. What makes you want to work for this company / organization?

3. Give me an assessment of your strengths and weaknesses as a person and the

work you have done?

4. What did you like best / least about your last job?

5. How would you envisage your future? Where would you like to be in 5 years?

Office :- Plot 81, Lebuhraya Kampung Jawa, 11900 Bayan Lepas, Penang
Tel:- 04-6422280/81/79/82/86 Fax:- 04-6422499

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