Pelita Akademi Sdn. Bhd.

Private & Confidential

EMPLOYMENT APPLICATION

POSITION APPLIED :

Personal Details

Fu ll :
Na me
I C No. :
Address : Sex :
Birth Date :
Age :
Race :
Nationality :
Telephone : (Hse) Marital Status :
(Off) No. of Children :
(if any)

Are you willing to relocate to another city / town ? Yes No

Are you willing to work shifts ? Yes No

Education / Qualifications
Year School / Institution Qualification

Any Other Training / Skills / Professional Qualifications

Employment History (Start with current / most recent employment)

Last Drawn Reason
From To Employer Position Salary for Leaving

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Salary Details

Current Salary : RM Expected RM

Salary :

Language Proficiency (Please tick the appropriate space)

Spoken Written
LANGUAGES Fair Good Fluent Fair Good Fluent

Family details (spouse, children, details of immediate family or parents, brothers and sisters)
Name Age Occupation

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Other Activities - Sports / Hobbies / Interests
Sports Hobbies Interests Others

Referees (Other than relatives)

Name : Name :
Occupation : Occupation :
Relationship : Relationship :
Telephone : Telephone :

Other Information

Period of Notice:

Are you or have you suffered from mental illness, Cancer, Aids, Yes No
Tuberculosis or any other illness or disablement.

Have you ever used or are you addicted to any narcotics or illegal substances? Yes No

Have you ever been convicted of a felony (other than traffic offenses)? Yes No

Do you have any relatives either directly or through marriage currently working Yes No
in PASB?
If Yes, please state the name of the person

Have you ever apply for any post in PASB previously? Yes No
No

Have you ever been employed by PASB or any of PASB group of Yes No
companies?

If yes, please state which department/group of companies

Declaration

I declare that the above information is, to the best of my knowledge, true and if after engagement it is found
that I have made a false declaration on the form, the company reserves the right to terminate my services without
any compensation.

Signature
Date :

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