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BORANG PERMOHONAN PROGRAM KIRANA BANGSA 2020 Rujuk Terma Dan Syarat Program Kirana Bangsa 2020 Di Lampiran A

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BORANG PERMOHONAN PROGRAM KIRANA BANGSA 2020 Rujuk Terma Dan Syarat Program Kirana Bangsa 2020 Di Lampiran A BORANG PERMOHONAN PROGRAM KIRANA BANGSA 2020 Rujuk Terma dan Syarat Program Kirana Bangsa 2020 di Lampiran A UNTUK KEGUNAAN PEJABAT Tarikh terima permohonan: Kelulusan: Lulus / Tidak Lulus SILA LEKATKAN Rujukan: Tandatangan: GAMBAR Catatan: Cop rasmi: Sila baca keterangan dibawah sebelum mengisi borang permohonan ini. 1. Borang ini hendaklah diisi dengan jelas dan lengkap menggunakan HURUF BESAR. 2. Pada ruangan-ruangan yang tidak berkenaan hendaklah ditulis dengan perkataan TIADA. 3. Tandakan (√) pada kotak yang berkenaan. 4. Borang yang tidak lengkap tidak akan diproses. 5. Pemohon mestilah berumur antara 18 – 30 tahun. 6. Dibuka HANYA kepada belia minoriti daripada golongan Orang Asli, Pribumi Sabah dan Sarawak. 7. Pemohon perlu mengemukakan resume lengkap dan salinan kad pengenalan. 8. Pemohon perlu menyediakan dan mengemukakan esei tidak melebihi 150 patah perkataan dengan Tajuk – Bagaimana Belia Minoriti Dapat Memberi Sumbangan Kepada Bangsa, Masyarakat dan Negara. (Penulisan Dalam Bahasa Malaysia) 9. Permohonan akan ditutup pada 16 Februari 2020 (Ahad). 10. Calon yang tidak menerima apa-apa maklumat selepas satu bulan dari tarikh tutup permohonan adalah dikira tidak berjaya. MAKLUMAT PEMOHON Nama Penuh: No. Kad Pengenalan: Umur: Alamat Tetap: No. Tel(HP): Kaum / Etnik: ( R ): Emel: Jantina: ( ) Lelaki ( ) Perempuan 1 / 3 Status Perkahwinan: ( ) Berkahwin ( ) Belum Berkahwin ( ) Duda/ Janda Alahan/ Penyakit: Ada / Tiada Nyatakan (Sekiranya Ada Penyakit): Pendidikan Tertinggi: Bidang Pengajian: Tahun Graduasi: Institusi Pengajian: Bilangan Ahli Keluarga (Adik Beradik) : ( ) 1-3 ( ) 4-6 ( ) 7-10 ( ) Melebihi 10 Pekerjaan Ibu: Bapa: Pendapatan Isi Rumah / Pendapatan Keluarga: ( ) RM4,360.00 dan ke bawah ( ) RM4,360.00 – RM9,619.00 ( ) RM9,619.00 dan ke atas WARIS Nama: Alamat: No. Tel: LATAR BELAKANG KERJAYA Tempat Jawatan Tahun PENGLIBATAN DALAM AKTIVITI BELIA / PROGRAM YANG BERKAITAN DALAM TEMPOH 5 TAHUN (2015-2019) Aktiviti / Program Anjuran / Peringkat Tahun 2 / 3 PERAKUAN PENGESAHAN PEMASTAUTIN OLEH WAKIL RAKYAT / SENATOR / PENGGAWA / PENGHULU / KETUA KAMPUNG / KETUA MASYARAKAT / SIDANG / PEGAWAI PEMBANGUNAN MUKIM / PENGERUSI JKKK (JAWATANKUASA KEMAJUAN DAN KESELAMATAN KAMPUNG) / KETUA ANAK NEGERI / KAPITAN / PEMANCA / PEGAWAI TAMAN Saya dengan ini mengesahkan bahawa pemohon adalah penduduk di tempat / kawasan ini. ______________________________ Tarikh: (Nama & Cop Rasmi) PENGAKUAN PEMOHON Saya mengaku bahawa semua keterangan yang telah saya nyatakan di dalam borang ini adalah benar. Saya sedar bahawa sekiranya ada di antara maklumat yang didapati tidak tepat/ palsu, permohonan dan pelantikan saya boleh dibatalkan serta merta. ______________________________ Tarikh: Tandatangan Pemohon Permohonan yang lengkap hendaklah dihantar ke pejabat Jabatan Belia dan Sukan Negeri (JBSN) berhampiran sebelum atau pada 16 Februari 2020 (Ahad). Senarai alamat lengkap pejabat JBSN adalah seperti di Lampiran B. 3 / 3 Lampiran A TERMA DAN SYARAT PROGRAM KIRANA BANGSA 2020 Program Kirana Bangsa dilaksanakan bertujuan untuk memberi peluang kepada belia Orang Asli, Pribumi Sabah dan Sarawak dalam sektor pekerjaan, meningkatkan kebolehpasaran serta mengasah bakat kepimpinan peserta. Peserta mestilah terdiri daripada keluarga kumpulan pendapatan M40 ke bawah dan berumur antara 18 tahun hingga 30 tahun. Tiga orang calon yang terpilih akan ditempatkan sebagai Pekerja Sambilan Harian (PSH) di Pejabat Y.B Timbalan Menteri Belia dan Sukan selama tujuh minggu dan seterusnya akan melaksanakan program pembangunan komuniti di tempat asal mereka selama dua minggu. Program bermula pada 23 Mac 2020 sehingga 15 Mei 2020. SYARAT-SYARAT PERMOHONAN & KRITERIA PEMILIHAN 1. Belia yang berumur antara 18 hingga 30 tahun. 2. Belia minoriti daripada golongan Orang Asli, Pribumi di Sabah dan Sarawak. 3. Berasal daripada keluarga kumpulan pendapatan M40 ke bawah (Kumpulan isi rumah berpendapatan purata bulanan bawah RM9,619.00). 4. Lepasan Ijazah Sarjana Muda. 5. Boleh berkomunikasi dalam Bahasa Malaysia dengan baik. 6. Boleh memberikan komitmen untuk mengikuti latihan praktikal sebagai Pekerja Sambilan Harian (PSH) di Pejabat Y.B Timbalan Menteri, Kementerian Belia dan Sukan selama tujuh minggu dan melaksanakan program pembangunan komuniti di tempat asal mereka selama dua minggu. STRUKTUR PROGRAM 1. Peserta akan berkhidmat di Pejabat Y.B Timbalan Menteri Belia dan Sukan, Kementerian Belia dan Sukan di Putrajaya. 2. Selama tujuh minggu peserta akan membantu menjalankan tugas-tugas pejabat, menghadiri mesyuarat dan persidangan parlimen, mengambil bahagian dalam perbincangan dan membantu kerja-kerja berkaitan media. 3. Dua minggu terakhir, peserta akan melaksanakan satu program pembangunan komuniti di tempat asal peserta bertujuan untuk membantu menangani pemasalahan belia di peringkat akar umbi. 4. Gaji yang ditawarkan adalah RM100.00 sehari. 5. Peserta tidak akan disediakan kemudahan pengangkutan dan penginapan sepanjang program berlangsung. 6. Calon yang tidak menerima apa-apa maklumat selepas satu bulan dari tarikh tutup permohonan adalah dikira tidak berjaya. Tarikh Tutup Permohonan ialah pada 16 Februari 2020 (Ahad). Lampiran B SENARAI ALAMAT JABATAN BELIA DAN SUKAN NEGERI 1. Pengarah Jabatan Belia dan Sukan Negeri Perlis Jalan Hospital 01000 Kangar Perlis Tel : 04-9793505 Fax : 04-9762555 2. Pengarah Jabatan Belia dan Sukan Negeri Kedah Aras 2, Zon A, Wisma Persekutuan Kompleks Pentadbiran Kerajaan Persekutuan Bandar Muadzam Shah, Mukim Anak Bukit 06550 Alor Setar, Kedah Tel : 04-7324500 Fax : 04-7311909 3. Pengarah Jabatan Belia dan Sukan Negeri Pulau Pinang Jalan Sultan Azlan Shah 11700 Gelugor, Pulau Pinang Tel : 04-6554444 Fax : 04-6574444 4. Pengarah Jabatan Belia dan Sukan Negeri Perak D/A Kompleks Belia dan Sukan Negeri Perak Jalan Ghazali Jawi 31400 Ipoh, Perak Tel : 05-5489500/05-5489501 Fax : 05-5489504 5. Pengarah Jabatan Belia dan Sukan Negeri Selangor Tingkat 5, Bangunan Plaza Perangsang, Persiaran Perbandaran, 40000 Shah Alam, Selangor Tel : 03-55192326 Fax : 03-55192231 6. Pengarah Jabatan Belia dan Sukan WP Kuala Lumpur Jalan Bukit Kiara 1 60000 Wilayah Persekutuan Kuala Lumpur Telefon : 03-20815800 / 03-20940990 Fax : 03-20956997 7. Pengarah Jabatan Belia dan Sukan Negeri Sembilan D/A Kompleks Belia dan Sukan Paroi 70400 Seremban, Negeri Sembilan Tel : 06-7613163/06-7641480 Fax : 06-7625569 8. Pengarah Jabatan Belia dan Sukan Negeri Melaka Jalan Tasek, Ayer Keroh 75450 Melaka Tel : 06-2345900/901/902/903 Fax : 06-2345905 9. Pengarah Jabatan Belia dan Sukan Negeri Johor Tingkat 3, Blok B, Wisma Persekutuan Jalan Air Molek, 80000 Johor Bahru, Johor Tel : 07-2232614 /07-2224485 / 07-2234487 Fax : 07-2234487 10. Pengarah Jabatan Belia dan Sukan Negeri Pahang Tingkat 5, Wisma Persekutuan, Jalan Gambut 25570 Kuantan, Pahang Tel : 09-5164354 Fax : 09-5162272 11. Pengarah Jabatan Belia dan Sukan Negeri Terengganu Jalan Pasir Panjang 21100 Kuala Terengganu, Terengganu Tel : 09-6222344/45 dan 09-6233693 Fax : 09-6236596 12. Pengarah Jabatan Belia dan Sukan Negeri Kelantan Kompleks Belia dan Sukan Panji 15200 Kota Bharu, Kelantan Tel : 09-7661200 Fax : 09-7667265 13. Pengarah Jabatan Belia dan Sukan (Persekutuan) Negeri Sabah Kompleks Belia dan Sukan (Persekutuan) Negeri Sabah Jalan Taman Pasir Putih, Putatan Mel Beg 81, 88998 Kota Kinabalu, Sabah Tel : 088-765777 / 088-761777 Fax : 088-765262 14. Pengarah Jabatan Belia dan Sukan Negeri Sarawak Aras 3, Kompleks Belia dan Sukan Negeri Sarawak Jalan Tun Ahmad Zaidi Adruce 93150 Kuching, Sarawak Tel : 082-240631 / 082-248321 Fax : 082-244537 15. Pengarah Jabatan Belia dan Sukan Wilayah Persekutuan Labuan Kompleks Sukan Wilayah Persekutuan Labuan Jalan Mohd Salleh, Peti Surat 80906 87019 Wilayah Persekutuan Labuan Tel : 087-415344 Fax : 087-415345 .
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