Recent Passport Size

JobStreet.com Sdn Bhd Photograph

Wisma JobStreet.com, No. 27, Lorong Medan Tuanku 1 (Off Jalan Sultan Ismail), 50300 Kuala Lumpur.
Main Line: (603) 2176 0333 Fax: (603) 2698 7200
No. 1, Ground Floor Office, Equatorial Hotel, 1 Jalan Bukit Jambul, 11900 Penang.
Main Line: (604) 644 5912 Fax: (604) 642 8653

FOR OFFICIAL USE

1st Interview by:
APPLICATION FOR EMPLOYMENT Date of Interview dd/mm/yyyy
nd
2 Interview by:
Position Applied For Date of Interview dd/mm/yyyy
Date Available For Employment Application Status:
Expected Salary Hire Reject Keep In View

PERSONAL PARTICULARS PAYROLL INFORMATION

Name (As appeared in NRIC) NRIC (Old) To be filled up by HR Department

NRIC (New) Employee No.

Preferred known as Passport No. Commencement Date

Permanent Address Birth Date End Date (Contract Only)

Gender Female Male Employment Term Permanent

Citizenship Contract
Correspondence Address (if any) Race Internship / Partime
Religion Work Location Penang
Marital Status S M D W Kuala Lumpur
Note: Marital Status : S = Single ; M = Married ; D = Divorced ; W = Widowed Johor Bahru
CONTACT INFORMATION Others _________
Email Address Home No. Job Grade

Mobile No. Designation

APPLICATION SOURCE Reporting Manager

How were you referred to JobStreet.com? Department

Section
By Referral, your friend's name: ________________________
Basic Salary
Website, please specify: _______________________________
Transport Allowance

Publication i.e. Magazine, Newspaper etc, please specify: ___________________ Handphone Allowance

Other Fix Allowance

Ex-Employee of JobStreet
When : EPF No

Which Department : RHB Bank Account No.

Immediate Manager : Income Tax No.

Division / Subsidiary : Socso No As per NRIC

Spouse Income Tax No.

SPOUSE INFORMATION (If married)

Spouse Name Spouse Working Y N
No of Children Below 18
Tax Exemption For Children Y N
FAMILY DETAILS
Name Relationship Age Occupation Place of Employment

IN CASE OF EMERGENCY NOTIFY

Name Relationship
Address Contact No.

EDUCATION INFORMATION (Please start with highest educational level)

Period Attended
Name of School/ Institutions Highest Standard Attained
From To
EMPLOYMENT HISTORY (Please start with your Present of Most recent employer)
From To Last Drawn Reason (s) for
Name of Employer Position Held
(MM/YY) (MM/YY) Basic Leaving

REFERENCE (Not Relatives)

Period Place of
Name Contact Details Occupation
Known Employment
Tel.:
Email:
Tel.:
Email:

If YES, please
SUPPLEMENTARY INFORMATION YES NO
provide details
a. Are you an ex-employee of JobStreet.com?
b. Are you an employee or ex-employee of any JobStreet.com direct competitors?
b. Do you have any friends or relatives presently working in JobStreet.com?
c. Have you at any time been convicted or found guilty of an offence by any court?
d. Are you bankrupt/ or being prosecuted due to financial difficulty/debts?
e. Have you ever been dismissed or suspended from work or requested to resign?
f. Have you had any serious illness within the last 5 years?
g. Are you suffering from any disability/ handicap?
h. Do you consume alcohol excessively?
i. Do you use any prescription drugs regularly?
j. Do you use illegal drugs?
k. Do you smoke?

I confirm that the above-stated information is true to the best of my knowledge and I have not wilfully suppressed any material fact. I give my consent for the Company to obtain
and verify information or with any source, as you deem appropriate for the assessment of my application for the employment. False particulars or suppression of material facts will
render you liable to disqualification and if appointed, to dismissal and/or appropriate legal proceedings.

I hereby agree that all statements I have made on this employment with JobStreet.com will be centralized in a Human Resources Database and JobStreet.com may store,
transmit and allow access to such data to any Human Resource and authorized personnel within JobStreet.com Corporation and its subsidiries

Signature of Applicant: Date: