Job Application Form Template

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WORK EXPERIENCE - JOB APPLICATION FORM

PRIVATE & CONFIDENTIAL

Photo

1. PERSONAL INFORMATION

Full Name:

NRIC/ Passport No: Date of Birth:

Email Address: Tel:

Nationality: [ ] Malaysian [ ] Others, please specify

Race: _________________________ Religion: __________________________

Emergency Contact (Name & Tel No.):

2. HEALTH

Do you have any allergies/health concerns we need to take note of?

[ ] No [ ] Yes (please state) ___________________

Have you had your Covid-19 vaccination?

[ ] No

[ ] Yes (state when)


____________________________________________________________________________________________________
____________________________________________________________________________________________________
__

3. SKILLS/OTHER STRENGTHS/PREVIOUS TRAINING OR EXPERIENCES (eg. ICT/CCA/Baking & Cooking Classes etc.)
4. LANGUAGES

Please Tick for Slight / Fair / Fluent


Language
Speaking Reading Writing

5. REFERRALS

Those acquainted with your skills/trainings are preferred eg. present Tutor(s) & past & immediate Coaches)

Name Address Telephone No. Designation Place of Work


1.
2.
3.

6. RECOMMENDATION

Relatives /friends in the above applied Companies or Organisations

Name Relationship

7. EXPRESSION OF INTERESTS - Maximum of 3 (Kindly rank your preferences with top choice being 1)

Job Description/Title Preference Organisation/Employer Reason

I declare that the information provided above is true and complete in all aspects. I understand that any misrepresentation
or omission of information may be considered sufficient for withdrawal of an offer or subsequent dismissal from work
experience placement.

_________________________________ ________________________________
Signature Date

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