Future Workers - Appendix B

PSMB/GRIP/1/16

1MALAYSIA GLOBALLY RECOGNISED INDUSTRY AND PROFESSIONAL

CERTIFICATION

(1MALAYSIAGRIP)

APPLICATION FORM

CATEGORY OF EMPLOYEE

Employee of HRDF Registered Employer

Please tick (√) where applicable

SUPPORTING DOCUMENTS TO BE ATTACHED

Copy of MyID (Identity Card)

Copy of Latest 1 Month Pay Slip

Please tick (√)

A. TRAINING INFORMATION

1 Course Title :

2 Start Date :

3 Completion Date :

4 Venue :

5 Training Provider :

1 B) TRAINEE INFORMATION

1 Name :

2 MyID Card No. : - -

3 Gender : Male Female

4 Address :

Postcode State:

5 Tel. No (Office) :

6 Tel. No (Handphone) :

7 Email :

8 Social Media : LinkedIn : ……………………………………………………..

Preference (please Facebook : …………………………………………………….. provide ID) Others : ………………………………………………………….. 9 Academic : Sijil Pelajaran Malaysia (SPM)

Qualification Sijil Tinggi Pelajaran Malaysia (STPM)

Certificate / Skills Certificate

Diploma

Bachelor Degree

Master Degree

Doctoral Degree

Others: ………………………………………

10 Specify Highest :

Academic

Qualification; 2 eg. Bachelor of Economics

11 Current Position : Manager Professional Technicians & Associate

Clerical Support Workers Service and Sales Workers

Skilled Agricultural, Forestry & Fishery Workers

Craft and Related Trades Elementary Occupations

Plant and Machine – Operators and Assemblers

12 Exact Position :

13 Current Monthly : Below RM800 for Sabah and Sarawak

Salary Range Below RM900 for Peninsular Malaysia

RM800 to RM1,999 for Sabah & Sarawak

RM900 to RM1,999 for Sabah & Sarawak

RM900 to RM1,999 Peninsular Malaysia

RM2,000 to RM3,999

RM4,000 to RM5,999

RM6,000 to RM7,999

RM8,000 to RM9,999

RM10,000 and above

14 Race : Malay Chinese Indian Others

(C) EMPLOYER INFORMATION

1 Name of Employer :

2 MyCoID (Company :

Registration Number)

- Compulsory 3 Industry : Manufacturing Service Agriculture

Construction Mining & Quarrying

Specify Sub sector:

4 Address :

3 Poscode State

5 Tel. No (Office) :

6 Fax . No. :

7 Contact Person (HR) :

8 HR Email Address :

D. EMPLOYER ENDORSEMENT

I hereby declare that the above mentioned trainee is an employee of our company

Signature : ...... …….. Company Stamp:

Name : ……………………………………….

Position : ………………………………………..

Date : …………………………………......

E. EMPLOYEE ENDORSEMENT

I declare that the facts stated in this application and the accompanying information are true and correct and I have not withheld / distorted any material fact.

Signature : ...... ………………………………

Name : …………………………………………………………………

MyID Card No. : …………………………………………………………………

4 Date : ………………………………………………………………...