PMO (PSD) Circular No 9/2008

Appendix A3 Please read instructions on the back page before you fill in this form. Attach additional pages if necessary. SINGAPORE*delete where CIVIL appropriate SERVICE (A) POSTS(S) APPLIED FOR (in order JOBof preference) APPLICATION FORMMinistry : Judiciary / State Courts

Are you prepared to consider posts other than those you have listed above? * Yes/No

(B) PERSONAL PARTICULARS

Full Name: ______Telephone No: ______(Mobile) (Underline Surname) ______(Office) ______( Home) ID Type:*NRIC(Pink)/NRIC(Blue)/Passport ID No: ______Email Address: ______Present Citizenship:  Singapore  Others (please specify): Highest Academic Qualification: Country : ______Year: ______

Held since: ______

Previous Citizenship (if any): ______

Permanent Residence (if any):  Singapore  Others (please specify):

Country : ______

Held since: ______

*Last/Current Employer : ______

Earliest date of starting work if offered appointment (e.g. immediately, within one month): ______

Monthly (S$) Annual (S$) *Last Drawn/Current Gross Salary Expected Gross Salary

(C) PRESENT & PREVIOUS EMPLOYMENT (in chronological order) Date Date Organisation Name Designation Brief Description of Job Duties & Major Achievements From To (to include type of employment, e.g. permanent/contract/casual) (D) RESULTS OF *GCE ‘N’/‘O’/‘A’ LEVEL OR EQUIVALENT

Qualification Level: Year: Qualification Level: Year:

Certificate Attained: Certificate Attained:

Institution Attended: Institution Attended:

Country of Study: No. of Passes: Country of Study: No. of Passes:

Subject Grade Subject Grade

(E) *LATEST/FINAL YEAR TERTIARY EXAMINATION RESULTS

Qualification Level (e.g. ITE/Diploma/Degree/Post-Graduate Degree/Doctorate): CGPA/CAP: _____ / _____

Certificate Attained: Year Obtained: Duration (YYMM):

Course Structure: Course Type: Course of Study: *On campus/Correspondence *Full-time/Part-time

Institution Attended: Country of Study: Institution Issuing the Country of Institution Qualification (if different from Issuing the Qualification: Institution Attended):

Subject Grade Subject Grade (F) MEMBERSHIP OF SOCIETIES, CLUBS AND ASSOCIATIONS Name of Societies/Clubs/Associations (in full) Date joined Position held

(G) CHARACTER REFEREES (Please provide particulars of two persons who are not related to you. They should be responsible persons who know you well with regard to your character and work performance. The Ministry may contact the referees stated.) Referee 1 Referee 2 Full Name Relationship Company Name, Designation Years Known Email Address Tel No.

CCA/SPORTS (Please enter only major/key activities)

Date From Date To CCA/SPORTS (Please indicate position held or level of participation)

AWARDS & PRIZES Year Description

ACADEMIC SCHOLARSHIPS & BURSARIES Date From Date To Sponsoring Name of Scholarships/Bursaries Bonded From Bonded To Organisation (year) (year)

SCHOOL ATTACHMENT/INTERNSHIP Date From Date To Name of Organisation Project Title and Description OTHER CERTIFICATIONS Certification Level: Certificate Attained: Institution issuing qualification: Country of Study: Year Obtained: Subject Grade Subject Grade

CURRENT PROFESSIONAL REGISTRATION Year of Local Overseas Registration

LANGUAGE PROFICIENCY

Language/Dialect Proficiency (Written & Spoken/Spoken only)

HOBBIES (Please indicate level of proficiency where applicable, e.g. Piano Gr V)

11. If your answer was “Yes” to any of the questions above, please give details :

(I) DECLARATION (1) I give my consent for the relevant Government authorities to obtain and verify information from or with any source, as you deem appropriate for the assessment of my application for employment.

(2) I declare that all information given by me in this application for employment and any sheets attached hereto are true to the best of my knowledge and I have not wilfully suppressed any material fact. I accept that if any of the information given by me in this application is in any way false or incorrect, my application may be rejected, any offer of employment may be withdrawn or my employment with the Civil Service may be terminated summarily or I may be dismissed from the Civil Service.

Signature of Applicant: ______Date:______

Instructions to applicants: 1. Attach one copy each of the following documents. (a) CV (b) Identity Card; (c) Citizenship Certificate (if applicable); (d) Certificates and Transcripts of Academic/Professional Qualifications; (e) Certificate of Service for Full-Time National Service (if applicable); (f) Copy of IR8E together with latest payslip (if applicable); and (g) Other Certificates or Testimonials to support your application.

2. Applications that are not properly completed or illegible may be rejected.

3. All information given by you in this application must be true. Giving false information is a crime punishable by imprisonment.

4. Please do not forward the originals, as these will only be required if you are subsequently called for an interview. If your original documents have been lost or mislaid, please obtain authenticated duplicates or certified true copies from the issuing authorities.