EXXONMOBIL ASIA PACIFIC PTE LTD

EXXONMOBIL CHEMICAL OPERATIONS PTE LTDHuman Resources Dept, Recruitment Section

EXXONMOBIL CHEMICAL ASIA PACIFIC1 Harbourfront Place #06-00 HarbourFront Tower One

Singapore 098633

APPLICATION FOR EMPLOYMENT

ALL DATES SHOULD BE ENTERED IN DD / MM / YY FORMATPRIVATE

PLEASE ANSWER ALL QUESTIONS FULLY IN YOUR OWN HANDWRITING

PERSONAL INFORMATION
Full name (As per NRIC / Passport ) / Date of Birth
(dd/mm/yy)
Nationality / Please attach recent photograph
If you a Singapore Permanent Resident, please provide date of obtaining PR
(dd/mm/yy)
Form of Salutation / (Mr /Mrs /Ms /Mdm) / NRIC No. / Passport No.
Contact Number
Home Office
Handphone Pager / Home / Mailing Address
Religion / Email Address
Race
Marital Status / Please indicate position applied for or the type of work you desire. / Do you have any restriction on overseas assignments? If yes, please state reasons.
Do you have any family members / relatives working for ExxonMobil? If yes, please name them.
Resignation Notice required (months) / Annual Gross Salary Desired (in S$)
NATIONAL SERVICE (IF APPLICABLE)
From / To / Duration / Unit / Appointment / Rank
If you have not completed National Service, please indicate current status (eg. exempted, disrupted, waiting for call-up, etc.)
FAMILY / RELATED PERSONS DETAILS (FOR PARENTS, SPOUSE & CHILDREN ONLY)
1. Name (per NRIC / Passport ) ______
Relationship ______Age or Birth Date (dd/mm/yy) ______
2. Name (per NRIC / Passport ) ______
Relationship ______Age or Birth Date (dd/mm/yy) ______
3. Name (per NRIC / Passport ) ______
Relationship ______Age or Birth Date (dd/mm/yy) ______
4. Name (per NRIC / Passport ) ______
Relationship ______Age or Birth Date (dd/mm/yy) ______
5. Name (per NRIC / Passport ) ______
Relationship ______Age or Birth Date (dd/mm/yy) ______
6. Name (per NRIC / Passport ) ______
Relationship ______Age or Birth Date (dd/mm/yy) ______
BONDS
Are you bound by any Bond to serve the Government, any statutory body Yes / No
or organization? If yes, please give details.
EDUCATION
Please attach photocopies of detailed result slips and educational certificates
Level of Education / Name of Institution/Location / Duration of Course / Course of Study / Highest Qualification Attained
From
(MM/YYYY) / To
(MM/YYYY)
Secondary
ITE / NTC
Pre-University
Junior College
Polytechnic
University
(First Degree)
Higher Degree (s)
Course Currently Pursuing
Professional or Other Qualifications
Computer Literacy Skills
Please list any prizes or awards gained
CO-CURRICULAR ACTIVITIES (CCA)
Level / ECA / Position / Responsibility Held
Secondary School
Pre-University
Junior College
Polytechnic
University
Current
LANGUAGES AND DIALECTS
Languages / Dialects / Indicate Slight / Fair / Fluent
Speak / Read / Write
EMPLOYMENT HISTORY
Please provide full employment history, including industrial attachments, if any.
Start with your latest employer
1) Name and Address of Employer
From
(MM/YYYY) / To
(MM/YYYY) / Position (s) / Last drawn basic salary
Other Allowances / Per Month
Guaranteed Bonus / Months
Variable Bonus, if any / Months
Please describe your duties and responsibilities
Reason for leaving
2) Name and Address of Employer
From
(MM/YYYY) / To
(MM/YYYY) / Position (s) / Last drawn basic salary
Other Allowances / Per Month
Guaranteed Bonus / Months
Variable Bonus, if any / Months
Please describe your duties and responsibilities
Reason for leaving
3) Name and Address of Employer
From
(MM/YYYY) / To
(MM/YYYY) / Position (s) / Last drawn basic salary
Other Allowances / Per Month
Guaranteed Bonus / Months
Variable Bonus, if any / Months
Please describe your duties and responsibilities
Reason for leaving
4) Name and Address of Employer
From
(MM/YYYY) / To
(MM/YYYY) / Position (s) / Last drawn basic salary
Other Allowances / Per Month
Guaranteed Bonus / Months
Variable Bonus, if any / Months
Please describe your duties and responsibilities
Reason for leaving
PERSONAL REFERENCE
References provided here should not be your family members.
Name / Name
Address / Address
Telephone No. / Telephone No.
Occupation / Occupation
No. of years you have known him/her / No. of years you have known him/her
EMERGENCY CONTACT
Name ______Relationship ______
Contact Address ______
Contact Number (Office) ______(Home) ______(Handphone) ______
OTHER INFORMATION
Are you holding any directorship / shareholder in any companies? (eg. it can be family business, profit or non-profit organization, any others). If yes, please give details. / Yes / No
Have you ever been convicted in a court of law?
If yes, please give details. / Yes / No
Have you ever been treated for drug and / or alcohol abuse?
If yes, please give details. / Yes / No
Has any bankruptcy action ever been taken against you?
If yes, please give details. / Yes / No
Have you any physical impairment and / or medical disability?
If yes, please give details. / Yes / No
Have you ever been dismissed from the services of any previous employer(s)?
If yes, please give details. / Yes / No
DECLARATION
“I authorize background 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 company’s service if I have been employed. I understand that employment is subject to satisfactory background investigation checks, including verification of my employment status with my present employer and a medical examination in which my health must be found to be satisfactory to the Company.
I acknowledge that all the above information and statements may be transferred to, accessed and/ or utilized by other entities now or hereafter within the ExxonMobil group of companies for consideration of my application and placement.”
Date / Signature of Applicant