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APPLICATION FORM
JOB PARTICULARS / BUTIR-BUTIR PEKERJAAN

Position Applied for / Jawatan dipohon Full Time / Sepenuh Masa Part Time / Separuh Masa

1st Preferences / Pilihan Pertama 2nd Preferences / Pilihan Kedua

Current Salary / Gaji Sekarang Expected Salary / Gaji dipohon

Notice of Resignation / Notis Pemberhentian Availability to commence / Tarikh boleh mula bekerja

PERSONAL DETAILS / BUTIR-BUTIR PERIBADI

Name in full (as in NRIC/Passport) Nama penuh (seperti dalam KP / Passport) Age / Umur

Correspondence / Current Address (Alamat surat menyurat) Date of birth / Tarikh Lahir:

Permanent / Hometown address (if different from above) / Alamat tetap Place of birth/Tempat Lahir:

NRIC (new) No. Kad Pengenalan (baru) NRIC (old) No. Kad Pengenalan (lama) Nationality / Warganegara

Gender / Jantina Race / Bangsa Religion / Agama

Height / Tinggi (cm) Weight / Berat (kg) Email Address

Tel. No. Home / Rumah Tel. No. Office / Pejabat Mobile No / Telefon mudah
Alih

Marital Status / Status Perkahwinan Number of Children /

Bilangan anak
Single / Bujang Married / Berkahwin Divorced / Bercerai

Active bank account / Income Tax No./ EPF No. / KWSP No.
Akaun bank yang aktif No Cukai Pendapatan

Will you work on shift / Overnight Class of vehicle qualified to SOCSO No. / No. Perkeso
Boleh bekerja shift / tengahmalam drive / Jenis lessen memandu

Yes No
LANGUAGE PROFICIENCY / KEMAHIRAN BAHASA
Understanding / Kefahaman Spoken / Pertuturan Writing / Menulis
Language /
Good / Baik Fair / Poor / Good / Fair / Poor / Good / Fair / Poor /
Sederhana Lemah Baik Sederhana Lemah Baik Sederhana Lemah
Bahasa

EDUCATION & PROFESSIONAL QUALIFICATIONS / PENDIDIKAN & KELAYAKAN PROFESIONAL

Area of qualifications / Jenis Name of school / institutions Duration / Certificate obtain / Kelayakan Grade /
Kelayakan Nama sekolah / institute Tempoh Gred
Secondary school /
Sekolah Menengah

University / College
Universiti / Kolej

Professional / Special Training

Latihan Professional

Software Application (Please specify)

Driving License First Aid Certificate Others (Please Specify)

EMPLOYMENT RECORD / REKOD PEKERJAAN (bermula dengan kerja terkini)

Name & Address of Employer / Duration of Position Held / Last Drawn Reason for Leaving / Sebab
Nama & Alamat Majikan Employment / Jawatan Salary / Gaji Berhenti
Tempoh di dalam disandang Terakhir
jawatan

General Information / Maklumat Am Yes No / If yes, please advise detail /

Please tick in the appropriate boxes (√) / Sila tanda di kotak berkenaan / Ya Tidak Jika ya, sila nyatakan
Have you ever been employed by in any of the subsidiary / Adakah anda pernah bekerja
di mana-mana anak syarikat?
Do you have any family relatives employed by our company/Adakah anda mempunyai
saudara-mara yang bekerja di syarikat kami?
Have you ever been found guilty of misconduct in your previous employment /
Pernahkah anda didapati bersalah melakukan salah laku di syarikat terdahulu?
Do you have any matters not yet cleared with your former employer / Adakah anda
mempunyai sebarang perkara yang belum diselesaikan dengan majikan terdahulu?
Are you now in pregnant, confinement or lactation period / Adakah anda sedang hamil,
berpantang atau menyusu?
Have you been convicted of a crime / Pernahkah anda disabitkan dengan jenayah?
Do you have physical disability, impairment, serious illness / Adakah anda mempunyai
kecacatan fizikal, kecacatan atau penyakit yang serius?
PARTICULARS OF IMMEDIATE FAMILY (SPOUSE, CHILDREN AND PARENTS)
Family Name Age Occupation Place of Occupation
Father
Mother
Spouse
Children
1.
2.
3.
4.

REFERENCE CHECK (please provide details of individuals who have worked with you)
Rujukan (sila berikan butiran individu yang pernah bekerja dengan anda)

Name Company Designation Contact No. / Email Address

PERSON TO NOTIFY IN CASE OF EMERGENCY (Orang untuk dimaklumkan jika terdapat kecemasan)
Full Name / Nama Penuh : Relationship / Hubungan :

Address / Alamat : Contact No / No Talifon :

DECLARATION

I hereby declare that the information given by me in this application for employment is true and complete and I agree and accept if any
part of my declaration is false or incorrect, my service may be terminated without notice or pay in lieu of notice. I also give my consent to
do reference check with my previous employer for purpose of verification.

PENGUMUMAN
Saya dengan ini mengumumkan bahawa keterangan-keterangan yang diberikan oleh saya untuk permohonan pekerjaan ini adalah
benar dan jelas. Saya bersetuju dan bersedia untuk ditamatkan perkhidmatan saya tanpa notis atau bayaran penganti notis sekiranya
pengumuman di atas didapati tidak benar. Saya juga membenarkan pihak ini membuat pemeriksaan rujukan dengan majikan sebelum
ini dengan tujuan pengeshan.

Singature / Tandatangan NRIC / No. KP Date / Tarikh

All applications will be treated with confidentiality and fairness. Thank you for your interest to join us.
 AUTHORIZATION FOR RELEASE OF INFORMATION FOR EMPLOYMENT PURPOSES

I ________________________________________________hereby authorize Crowne Plaza Penang Straits City and its designated
representatives to conduct a comprehensive review of my background check for employment, promotion, re-assignment or retention as
an employee. I understand that the scope of the background check may include, but is not limited to, the following areas: names and
personal dates of previous / current employment, work experience, educational verification, workers’ compensation, medical records,
disciplinary records and criminal history record.

I also authorize the complete release of these records or data pertaining to me which an individual, company, firm, corporation or public
agency may have, I authorize the full release of the information described above, without any reservations.

I hereby release Crowne Plaza Penang Straits City and its designated representatives both individually and collectively, from any and
all liability for damages of whatever kind, which may at any time, result to me, my heirs, family or associates because of compliance with
this authorization for release form. I certify that all information provided below and on my resume is correct to the best of my knowledge.

Any false statements provided in this form and my resume will be considered just cause for the termination of employment at any time.

This authorization and consent shall be valid in original, fax, email or copy form. The following information is required by law enforcement
agencies and other entities for identification purposes when checking records. It is confidential and will not be used for any other purpose.

Singature / Tandatangan NRIC / No. KP Date / Tarikh

 Rating: 5=Outstanding 4=Good 3=Acceptable 2=Fair 1=Unsatisfactory

Interview Evaluation
1st Interview - HR Department 2nd Interview - Head of Department

Rating Comment Rating Comment

Attitude

Grooming / Presentation

Quality & Professionalism

Language & Skills

Service Orientation

Teamwork

Openness to Innovation

Proactive Pursuit of Excellence

Analytic Thinking
(For Manager)
Commitment / Talent Development
(For Manager)
Communication & Influence
(For Manager)

Interviewer Name

Interviewer Signature / Date

Recommendation Reject / KIV / Offer Reject / KIV / Offer

HIRING CONFIRMATION

New Hire Replacement

Position : _____________________________________ Department / Section : ____________________________

Join Date ___________________________ Salary Offer : RM __________________ Job Band : _____________

APPROVAL BY :

Department Head : _________________________ Human Resources Manager : _______________________

Date : _________________________ Date : _______________________

General Manager : __________________________ Date : _______________________