KLK OLEOCHEMICAL GROUP

POSITION APPLIED :

(A) PERSONAL PARTICULARS

Name in Full
(in block letters & as
per NRIC)

Attach Recent
Postal address Photograph

Home address

Email Address
Telephone No. (H) Mobile
Date of birth NRIC
Place of Birth Race
☐ Male
Sex Age1 Religion
☐ Female
Citizenship Marital Status

Name of Spouse NRIC Contact No Occupation

Names of Children Age Occupation

Names of Parents Occupation Organisation

Names of Brothers/Sisters Age Occupation Company

1 It is the company’s policy to only recruit those 18 years old and above.
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(B) EDUCATION (Please enclose photocopies of certificates & results)
QUALIFICATION & FIELD OF STUDY INSTITUTION / UNIVERSITY / FROM TO GRADE
(i.e. Bachelor’s Degree in Chemistry) COLLEGE / SCHOOL (mm/yy) (mm/yy)

MEMBERSHIP IN PROFESSIONAL BODIES

Name of Institution From To Membership status
(mm/yy) (mm/yy)

EXTRA CURRICULAR ACTIVIES / INTERESTS / HOBBIES

LANGUAGE PROFICIENCY

Language(s) Spoken Language(s) Written

Bahasa Malaysia ☐ Advance ☐ Moderate ☐ Basic ☐ Advance ☐ Moderate ☐ Basic

English ☐ Advance ☐ Moderate ☐ Basic ☐ Advance ☐ Moderate ☐ Basic

Others (pls specify): ☐ Advance ☐ Moderate ☐ Basic ☐ Advance ☐ Moderate ☐ Basic

Others (pls specify):

☐ Advance ☐ Moderate ☐ Basic ☐ Advance ☐ Moderate ☐ Basic

(C) EMPLOYMENT RECORD (start with present job, list in backward sequence every employment you have had)
*Please attach additional pages or CV for more employment history if necessary.
From To
(1) Name of Employer Industry Location
(mm/yy) (mm/yy)

Position Position of Immediate Superior

Starting Salary (Basic) Last drawn Salary (Basic)
Allowances & Benefits
Job Function

Reason for Leaving

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 From To
(2) Name of Employer Industry Location
(mm/yy) (mm/yy)

Position Position of Immediate Superior

Starting Salary (Basic) Last drawn Salary (Basic)
Allowances & Benefits
Job Function

Reason for Leaving

From To
(3) Name of Employer Industry Location
(mm/yy) (mm/yy)

Position Position of Immediate Superior

Starting Salary (Basic) Last drawn Salary (Basic)
Allowances & Benefits
Job Function

Reason for Leaving

(D) EMPLOYMENT NOW SOUGHT

Expected Salary
Date available for employment
Other relevant information in
support of application

(E) CHARACTER REFERENCE (Not Relatives; immediate superior preferred)

May we contact your past / present employer for employment reference?
If yes, please specify two referees and their contact numbers.
a) Name b) Name
Occupation Occupation
Company Company
Relationship Relationship
E-mail E-mail
Telephone Telephone

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(F) PRIVACY OF PERSONAL INFORMATION
I hereby give my consent for my personal data to be used for the purposes of processing matters relating to my application for employment, as
personnel record within KLK Group of Companies.

If I am employed, I give consent for my personal data to be used for the purposes of processing matters relating to my employment as personnel
record with the Company human resource’s strategies, travelling arrangement, payroll system, human resource system, insurance coverage,
business communication and transaction, statutory requirements, auditing by internal and external auditors and any other purpose that is
incidental or in furtherance to the above-stated purposes.

I shall not withdraw any data that may affect the efficiency of recording and arrangement of matters relating to my employment, performance
and/or medical health results or report relating to my health condition while in employment with the Company.

I have been informed that my personal data can be updated or withdrawn with my written request to the Company’s Human Resource Department
or any other personnel designated to handle payroll/human resource matters, provided that the request is reasonable and does not disrupt the
operations’ requirement.

I have read and fully understand the contents of the Company’s Privacy of Personal Information.

(G) DECLARATION
1. Have you ever worked in this Company or in KLK Group of Companies before?
☐ No ☐ Yes : Company

From To
2. Do you have any relatives working in this Company or in KLK Group of Companies?
☐ No ☐ Yes : Name Relationship
3. Have you ever attended interview with this Company or in KLK Group of Companies?
☐ No ☐ Yes, please specify :

4. Do you have any serious illness or contagious disease? e.g. hepatitis, H1N1, Aids, Tubercolosis, etc…
☐ No ☐ Yes, please specify :
5. Have you ever been convicted of a criminal offence / Is there any criminal case pending against you?
☐ No ☐ Yes, please specify :
6. Potential conflict of interest:
- Family member(s) working for competitor / business partner companies of KLK Group of Companies?
☐ No ☐ Yes, please specify :
- Any outside business / interests beyond employment?
☐ No ☐ Yes, please specify :
*IMPORTANT - If you answered ‘Yes’ to any of the above, please discuss with the interviewer whether it may impact your ability to carry
out duties assigned in the position you are applying for.

I hereby declare that all the information and answers provided by me in this application are true and correct to the best of my knowledge. I
authorise verification of all statements and answers to questions herein if I am considered for employment. I understand that a misrepresentation
or omission of facts called for herein will be sufficient cause for dismissal without compensation from the Company’s service if I have been
employed.

Signature: Date:

Name: NRIC:

OFFICIAL INTERNAL USE

Proposed Position:
Proposed Salary Range:
Proposed Commencement Date:

Recommended by HOD Supported by HRD Rejected / Approved by: MD / ED / GM

_________________________ _________________________ _________________________

Name: Name: Name:

Remarks (if any):

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