Discharged Bankrupt

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					                         EZRA GROUP OF COMPANIES
                         80 Marine Parade Road #15-01/02 Parkway Parade Singapore 449269
                         Tel : (65) 6742 6765    Fax : (65) 6742 5286

                                          JOB APPLICATION FORM


Full Name                                                  Name                                       Recent
                                                                                                   Passport Size
(as in NRIC) in Block Letters & Underline Surname          (in Chinese Character, if applicable)    Photograph

Address                                                    Tel No. (Home)

                                                           Tel No. (Office)

                                                           Handphone No.

                                                           Email Address

Citizenship                                    Place of Birth                                Sex

                                                                                             * Male / Female

Driving Licence (Class) :                      Date of Birth (DD/MM/YYYY)                    Age


Identity Card                                              Singapore Permanent Resident            * Yes / No.

NRIC No. :                                                 If yes, please state PR Issuance Date

Colour : * Pink / Blue

Ethnic Group                     Religion                  Passport

                                                           (Not applicable to S'poreans & S'pore PR)

Marital Status                                             Passport No.

*Single / Married / Windowed / Divorced                    Place of Issue

FAMILY PARTICULARS (Please include parents, spouse, siblings and children)

Name                                      Relationship     Age        Occupation                   Employer

* Delete whichever is not applicable                                                                      Page 1 of 4
NATIONAL SERVICE (Applicable only for Male, Singapore Citizen or Permanent Resident of Singapore)

Date Enlisted                               Date Discharged                           Actual Period served

Period of Regular / Contract Service        Vocation / Rank                           PES Grading

* Yes / No

Are you exempted from reservist training ? ( If "yes", please attached a copy of Exemption Letter)         * Yes / No

Are you exempted from national service ? ( If "yes", please attached a copy of Exemption Letter)           * Yes / No

EDUCATION (List schools/institutions/universities attended.)

From         To            Schools/Instituition/Universities attended          Qualifications Obtained


Date Obtained              Qualifications                                      Awarding Institution


(Please provide details of any Scholarships / Awards held including value, duration, period of bond, if any & effective date.

LANGUAGE PROFICIENCY (Please State Profiency E.g. Excellent, Good, Fair)

Language                   Written & Spoken                                    Spoken Only


                                                                                                               Page 2 of 4

1. Present Appointment / Last Job Appoinment

Position                                                   Reporting To

Name of Organisation / Employer                            Date Join / Date left

Address of Organisation / Employer                         Compensation (Monthly Salary / Allowances / AWS / Bonus)

Brief Description of Job Responsibilities / Scope

Please draw your current Organisarion Chart

Reason for intended change of employment

2. Previous Appointments (Please list in chronological order)

Dates                     Position Held             Org's / Employer's         Last drawn      Reason for

From         To                                     Name and Address           Mthly Salary    leaving service

                                                                                                          Page 3 of 4

 1 Have you ever been convicted in a court of law of any country ?                                       * Yes / No

 2 Have you ever been dismissed, discharged or suspended from employment?                                * Yes / No

 3 Are you suffering from any handicaps, ailments, disease or is under long term medication?             * Yes / No

 4 Have you ever been declared bankrupt ?                                                                * Yes / No

 5 Do you have any friends / relatives working in EZRA Group of Companies?                               * Yes / No

   If your answer is "Yes" to any of the questions above, please provide details :


Name                                                                     Occupation

Relationship                                                             Period No.

Address                                                                  Contact No.

Name                                                                     Occupation

Relationship                                                             Period No.

Address                                                                  Contact No.

If Offered Employment :

Notice Period Required                       Earliest Start Date                 Salary Expectation

                                             (DD/MM/YYYY)                        Monthly SGD

                                                                                 Annual    SGD


I authorise investigation of all statements contained in this record if I am considered for employment. I understand that

a misrepresentation or omission of facts called for herein will be sufficient cause for cancellation of consideration for

employment or dismissal from the service if I have been employed. I understand that employment is subject to medical

examination in which my health must certify as fit for employment.

Signature of Applicant                                                Date

                                                                                                                 Page 4 of 4

Description: Discharged Bankrupt document sample