Ref No.

PRIVATE & CONFIDENTIAL

Photo

APPLICATION FORM
Position Applied For:
Preferred Location:

(1)

(2)

Expected Salary:

RM

Availability:

(3)
(

) Immediately

(Notice Period)

PERSONAL PARTICULARS
Full Name:

Gender:

Name in Chinese
Characters (if any):
(

) Male

) Female

Current Address:

Emergency Contact No.

Home No.
Mobile No.
E-mail:

NRIC/Passport No.

Date of Birth:

Age:

Hometown:

Nationality:

Race/Religion:

Marital Status:

Height/Weight:

Driving License:

D / Others (

Own Transportation:

) Car

) Bike

Interests:

Agensi Pekerjaan Career Medi (M) Sdn Bhd - Application Form

Page 1

FAMILY BACKGROUND
Name of Family

Relationship

Age

Occupation

EDUCATION BACKGROUND
Name of Institution

Location

Year
From

To

Qualification Obtained

LANGUAGE SKILLS
English:

Bahasa Malaysia:

Mandarin:

Japanese:

Others:
(

Spoken

Excellent

Good

Fair

Poor

Written

Excellent

Good

Fair

Poor

Reading

Excellent

Good

Fair

Poor

Spoken

Excellent

Good

Fair

Poor

Written

Excellent

Good

Fair

Poor

Reading

Excellent

Good

Fair

Poor

Spoken

Excellent

Good

Fair

Poor

Written

Excellent

Good

Fair

Poor

Reading

Excellent

Good

Fair

Poor

Spoken

Excellent

Good

Fair

Poor

Written

Excellent

Good

Fair

Poor

Reading

Excellent

Good

Fair

Poor

Spoken

Excellent

Good

Fair

Poor

Written

Excellent

Good

Fair

Poor

Reading

Excellent

Good

Fair

Poor

Agensi Pekerjaan Career Medi (M) Sdn Bhd - Application Form

Page 2

COMPUTER SKILLS
Microsoft Office:
(Excel/Word/Powerpoint/Access)

Excellent

Good

Fair

Poor

Internet:

Excellent

Good

Fair

Poor

Excellent

Good

Fair

Poor

Others (please specify):

(

WORKING EXPERIENCE
* Please commence by stating your present employment
Company Name
& Location

Period Employed
From

To

Position

Summary of Responsibilities

Reason for
Leaving & Salary

SELF INTRODUCTION

Agensi Pekerjaan Career Medi (M) Sdn Bhd - Application Form

Page 3

How did you get to know about Career Medi?

Through:
Career Medis
Website

Friend

Newspaper (please specify):

(
)

Internet (please specify):

(

REFERENCES

Name:

Contact No.

Company & Position:

Relationship:

Applicants Signature

Agensi Pekerjaan Career Medi (M) Sdn Bhd - Application Form

Date

Page 4