PMC / LTC / STC EMPLOYMENT APPLICATION FORM

1 PMC / LTC / STC EMPLOYMENT APPLICATION form PERSONAL DETAILS Name Address IC Number & Colour Citizenship Date of Birth Gender Driving Licence No Own Transportation (Y/N) Marital Status CONTACT DETAILS Phone (1) Phone (3) Phone (2) E-Mail Address QUALIFICATIONS Qualification Issuing Institution Result Year Masters / Professional First Degree HND A Level O Level Others: WORKING EXPERIENCE Employer Name Job Title Period Reason For Leaving Attach Photo Here WFD/0 Finance & Administration Department BIBD AT-TAMWIL BERHAD Unit 1, Bangunan Ibu Pejabat Persekutuan Pengakap, BE4119 Negara Brunei Darussalam REFEREES Name Relationship Contact Number ADDITIONAL INFORMATION / PERSONAL STATEMENT EMERGENCY CONTACT PERSON Name Contact Number Relationship DECLARATIONS (Please Circle) 1.

2 Have you ever been convicted of any felony(ies) or crime(s) in Brunei or elsewhere? Y / N 2. Have you ever cheated any persons or companies or have overdue outstanding financial obligations? Y / N 3. Do you currently have any family member(s) or relative(s) currently working with BIBD At-Tamwil Berhad or BIBD? Y / N 4. Do you have any serious medical or physical problem which may affect your job performance? Y / N 5. Would you accept assignment in any of BIBD At-Tamwil Berhad s Branches? Y / N 6. Are you willing to accept any short-term or temporary EMPLOYMENT ? Y / N 7. If selected, I agree and consent to abide by all terms and conditions of my contract of service.

3 Y / N 8. I am planning to continue my studies. Y / N 9. I am willing to work extra hours as and when required by the Company if selected. Y / N 10. The information I have supplied on this form is correct. I understand that giving false information or omitting relevant information will disqualify my APPLICATION or lead to my summary dismissal. Y / N Signature : .. Name : .. Date : .. FOR WFD USED ONLY: Candidate Result Review by: Endorse by: To be Interview KIV Initial: Initial: Reject Job Indicator: Job Indicator: Others Date: Date.