JOB APPLICATION FORM
(Academic / Administrative Staff)

 
 
 
Position Applied for: *
 
Please affix a recent photograph
 
(File size limit, 4Mb)  


1.   PERSONAL DETAILS
Title & Full Name as in Passport / Identity Card (underline Surname / Family Name):  
Prof / Dr / Mr / Mrs/ Ms *  
*  
Identity Card Number (New) : - - * Nationality: *
Date of Birth: 19 * Place of Birth: *
Age: * Gender:
Race: * No of Children:
Home/ Permanent Address: Postal/ Residential Address:
* *
(Postcode) * (Postcode) *
(Town) * (Town) *
(State/ Country) * (State/ Country) *
Telephone No: - Telephone No.(Residential) : (Mobile) :
E-mail Address: * - -
* Marital Status : Single          Married           Widowed          Divorced 
   
Details of Spouse Details of Father/ Guardian
   
Name of Spouse: Name of Father/ Guardian:
Occupation: Occupation:
Employer's Name: Address:
  Contact No: -
   

2. EDUCATIONAL QUALIFICATION (In chronological order)
Name of Institution
(High School / College / University)
Qualifications
(Field of Study, Grade, Award Classifications, etc)
Country
Date
(MM/YYYY)
From
To
*
*
*
* *

  Title of Masters / Doctorate Dissertation:
   
  (Maximum 150 characters.)
 


3. PROFESSIONAL QUALIFICATION/MEMBERSHIP
Name of Professional Body
Qualification/Membership
Date
(MM/YYYY)


4. RESEARCH/CONSULTANCY/PUBLICATION & OTHER SCHOLARLY ACTIVITIES
Title of Project and Non-technical Description of Progress of Research/ Consultancy/ Publication Currently Undertaking
Duration


Language Proficiency (written) English Malay Mandarin
  (spoken) English Malay Mandarin
  Others (Please Specify) :


5. WORKING EXPERIENCE (In chronological order)
Designation
Employer
Salary Per Month(RM)
Employment
(MM/YYYY)
From
To
Reason for Leaving

Notice of Resignation required for present employment: Expected Salary (MYR):

Only Applicable to Academic Staff:

Teaching Permit:       Yes (a copy to be submitted) No (have applied)  No (have not applied)
Teaching Permit No.  Validity: From to (DD/MM/YYYY)

6. GENERAL INFORMATION
Have you received any scholarship/award that requires you to serve a bond?
Yes       No   
 
If yes, please specify period of bond & organisation that you are/were bonded to.
Duration of Bond From to Name of Organisation
 
If you have not successfully completed the bond, please provide details.
 
 
 

7. REFEREES
Please provide names of referees who are not relatives

Name of Referee

Designation & Name of Employer

Address

Phone No.


8. DECLARATION & CONSENT
Have you ever been accused of committing a criminal offense?
Yes       No    *

If Yes:
Any *physical disability/serious illness you are suffering from
Names of relatives who are currently working in the University Colege


I hereby declare that all information provided in this form is complete, accurate and true. If any of the information contained herein is found to be untrue, Tunku Abdul Rahman University College reserves the right to terminate my appointment and/ or take any other action as it deems appropriate.

I agree that the University College may process the information contained in the form for employment purpose and to disclose such information to government/ regulatory authorities if so required.

I understand that the information provided by me and my details in the University College records may be released to government, legislative and enforcement agencies and where these information is required to comply with any laws or regulatory requirements.