MMHE Application Form Rev1

MALAYSIA MARINE AND HEAVY ENGINEERING SDN. BHD. (14558-P)

PLO 3, Jln Pekeliling, P.O. Box 77, 81700 Pasir Gudang, Johor
(A subsidiary of Malaysia Marine and Heavy Engineering Holdings Berhad)

APPLICATION FOR EMPLOYMENT

PERMOHONAN JAWATAN
PLEASE READ THE INSTRUCTIONS CAREFULLY/ SILA BACA ARAHAN BERIKUT DENGAN TELITI:
1. Please fill up the relevant columns in this form by TYPING in BLOCK LETTERS.
(Sila lengkapkan maklumat berkaitan di dalam borang ini dengan MENAIP menggunakan HURUF BESAR)
2. Please attach a photocopy of your NRIC/ Passport, academic certificates/ transcript, latest three months’ pay slips and other
relevant documents.
(Sila lampirkan salinan kad pengenalan/ Passport, sijil akademik/ transkrip, slip gaji 3 bulan terkini dan sebarang dokumen yang berkaitan).

POSITION APPLIED FOR: EXECUTIVE, CONTRACT

(Jawatan Dipohon)

1.0 PERSONAL DETAILS/ BUTIR-BUTIR PERIBADI

Name as per NRIC/ As per NRIC or passport / Seperti di dalam kad pengenalan atau passport)
Passport MAISARAH ZUHAIRAH BINTI ZULKIFLI
(Nama Penuh)
Correspondence
Address NO. 66, JALAN ELEKTRON, U16/89 DENAI ALAM, 40160 SHAH ALAM, SELANGOR DARUL EHSAN
(Alamat Surat-Menyurat)

Phone No. Nationality NRIC/ Passport No.

(No. Telefon)
016-3428051 (Warganegara)
MALAYSIAN (No. Kad Pengenalan/ 901209-15-5096
Passport)
Validity Period
E-mail Address maisarah.zuhairah Date of Birth 09 DECEMBER 1990 (Tempoh Sah Passport)
(Alamat E-mail) @gmail.com (Tarikh Lahir) *Expatriate Only
* Passport No. is applicable for non-Malaysians only. For Malaysians, please provide NRIC.
2.0 ACADEMIC QUALIFICATION/ KELAYAKAN AKADEMIK (Not required if complete details are available in resume provided)
Name of Institution Qualification/ Major Result Year Obtained
(Nama Institusi/ Sekolah) (Kelulusan/ Jurusan) (Keputusan i.e.: CGPA) (Tahun Diperoleh)

PROFESSIONAL/ TERTIARY/ SECONDARY

(PROFFESIONAL/ PENDIDIKAN TERTINGGI/ PENDIDIKAN MENENGAH)
UNIVERSITI TEKNOLOGI MARA DIPLOMA IN QUANTITY SURVEYING 2.74 2012

UNIVERSITI TEKNOLOGI MARA BACHELOR OF QUANTITY 2.62 2016

SURVEYING (HONS)

MEMBERSHIP OF PROFESSIONAL BODIES (KEAHLIAN BADAN PROFESIONAL)

3.0 WORKING EXPERIENCE/ PENGALAMAN BEKERJA (Not required if complete details are available in resume provided)
Name Present/ Previous Monthly Date Left
Position Date Joined Reason for Leaving
Company (Jawatan) Salary (Tarikh Mula)
(Tarikh
(Sebab Berhenti)
(Majikan Terkini/ Terdahulu) (Gaji Bulanan) Berhenti)
BAYANGAN SEPADU SDN BHD ASSISTANT QUANTITY SURVEYOR N/A 2011 2012 FURTHER STUDY
MMC GAMUDA (KVMRT-PDP) SDN BHD QUANTITY SURVEYOR N/A 2016 2018 CAREER DEVELOPMENT

PENGURUSAN AIR SELANGOR ASSOCIATE III RM4,872.00 2018 -

SDN BHD
 MMHE Application Form Rev1

4.0 GENERAL INFORMATION/ MAKLUMAT AM (* Strictly for recruitment purposes/ job risk assessment and suitability)
Yes/ No/
DETAILS (Keterangan) Ya Tidak
Do you have any physical disabilities/ medical illness/ chronic disease/ mental illness/ color blind? If
‘Yes’ please provide details: *
(Adakah anda mempunyai ketidakupayaan fizikal/ penyakit perubatan/ penyakit kronik/ penyakit mental/ buta warna? Jika 'Ya', sila berikan
maklumat terperinci):

Do you depend on any medication? If ‘Yes’ please provide details: *

(Adakah anda bergantung kepada sebarang ubat-ubatan? Jika ‘Ya’ sila berikan maklumat terperinci):

Have you been employed by MMHE, MISC Berhad, PETRONAS and/ or its Group of Companies? If ‘Yes’
please provide details:
(Adakah anda pernah berkhidmat dengan MMHE, MISC Berhad, PETRONAS dan/ atau mana-mana anak syarikat? Jika ‘Ya’sila berikan
maklumat terperinci):

Have you been barred from entering any MMHE, MISC Berhad, PETRONAS and/ or its Group of
Companies? If ‘Yes’ please provide details:
(Adakah anda pernah dihalang daripada memasuki mana-mana premis MMHE, MISC Berhad, PETRONAS dan/atau Kumpulan Syarikatnya?
Jika ‘Ya’ sila berikan maklumat terperinci):

Do you have any family(s)/ relative(s) working in MMHE and/ or its Group of Companies? If ‘Yes’ please
provide details:
(Adakah anda mempunyai ahli keluarga yang bekerja di MMHE dan/ atau di mana-mana anak syarikat? Jika ‘Ya’ sila berikan maklumat
terperinci):

Do you have any family(s)/ relative(s) conducting business activities involving MMHE, MISC
Berhad, PETRONAS and/ or its Group of Companies? If ‘Yes’ please provide details:
(Adakah anda mempunyai ahli keluarga yang menjalankan perniagaan yang melibatkan MMHE, MISC Berhad,PETRONAS dan/ atau mana-
mana anak syarikat? Jika ‘Ya’ sila berikan maklumat terperinci):

Do you have a valid CIDB Green Card? If ‘Yes’, please specify the CIDB Green card expiry date:
(Adakah anda mempunyai CIDB Kad yang masih sah tempoh? Jika ‘Ya’, sila nyatakan tarikh tamat tempoh:)

Do you have any competency from CIDB? If ‘Yes’ please specify type of competency from CIDB.
(Adakah anda mempunyai kecekapan daripada CIDB? Jika ‘Ya’, sila nyatakan jenis kecekapan dari CIDB:)

Are you willing to serve anywhere in Malaysia or overseas?

(Adakah anda sanggup berkhidmat di mana-mana lokasi dalam Malaysia atau di luar negara?)

Notice Period Required: Expected Monthly Salary: 10,000.00

(Notis berhenti yang diperlukan): 3 MONTHS (Gaji bulanan yang dipohon):
RM

REFEREES/ RUJUKAN (Not required if complete details are available in resume provided)
Name Company Name Position Tel No./ Email
(Nama) (Nama Majikan) (Jawatan) (No. Tel/ Email)

PENGURUSAN AIR SELANGOR 012-9318826

MOHD ARIF BIN OTHMAN SDN BHD
Assistant Vice President I

PENGURUSAN AIR SELANGOR

NURUL ATIQAH BINTI ROSZOPOR
SDN BHD ASSOCIATE I 017-391 0957

DECLARATION & CONSENT/ PENGAKUAN & PERSETUJUAN

I declare that all particulars in this application and the sheets hereto are true in every aspect. I understand that if any of the
particulars supplied by me are proved untrue, I am liable to be summarily dismissed. I have not willfully suppressed any material
fact.

Personal Data Protection (Act 2010 – PDPA)

I, the undersigned, refer to the MMHE Personal Data and Information Notice (“Notice”) which has been provided to me. I hereby
confirm my consent and authorization (and that I have duly received the required consents and authorizations of all the other
parties) for MMHE to process any Personal Data given by me for the recruitment purposes, as stated and in accordance with the
Notice.

Saya mengakui bahawa segala butir-butir di dalam borang ini dan lampiran-lampiran adalah betul dan benar. Sekiranya didapati butir-butir yang diberikan tidak betul
atau benar, saya akan dipertanggungjawab untuk sebarang tindakan (termasuk dipecat dari jawatan) saya tanpa syarat. Saya akui bahawa saya tidak
menyembunyikan sebarang maklumat.

Akta Perlindungan Data Peribadi 2010 – PDPA

Saya, merujuk kepada MMHE Notis Data Peribadi dan Maklumat yang dimaklumkan kepada saya. Saya mengakui memberikan persetujuan dan kebenaran untuk
MMHE memproses sebarang Data Peribadi yang telah saya berikan untuk tujuan pemprosesan pekerjaan, seperti yang telah dinyatakan di dalam notis.

Signature: Date: 6 MARCH 2024

Tandatangan: Tarikh: