PRIVATE & CONFIDENTIAL 8 Cross Street #17-00 PwC Building Singapore 048424 Main Line: 6236 3388 HR Confidential Fax: 6236 4155 Website address: http://www.pwc.com/sg JOB APPLICATION FORM Position Applied for (please tick where applicable) Assurance Tax Advisory Temporary Assistant Others Referral (please specify) Job Source (please tick where applicable) Newspapers/ “Opportunities” Unsolicited Other job Sites Please enclose: 1) Photocopies of detailed professional, university, polytechnic, ‘A’ and ‘O’ Level results (or its equivalent) 2) Photocopies of school leaving certificates and testimonials 3) Photocopies of all work and other references, including National Service Certificate of Conduct, if applicable 4) Photocopies of NRIC for local, Entry and Re-entry permits for SPR or Passport for foreigners Available Period: (DD/MM/YYYY – DD/MM/YYYY) Personal Particulars Name as in NRIC / Passport : (Please underline Surname / Family Name) Preferred Name to be Known in Office: (No Nickname or Initials) Nationality : Country of Birth : NRIC / FIN / Passport Number & Expiry Date : Date of Birth : Gender : Male / Female Marital Status : For Non-Singaporean, please complete the following Singapore PR : Yes / No Date Granted SPR : UIN No : Malaysian IC : Contact Details Home Address : Mailing Address (if different from Home Address) : Residence Telephone No: Mobile No: E-mail: National Service (if applicable) Reservist Status : Completed from : Rank : Performance : Reservist / Waiting for Call-Up / Exempted / Completed / Not Applicable / / to / / Exempted on Account of: Vocation : Outstanding / Very Good / Good / Satisfactory / Unsatisfactory Languages and Dialects (state proficiency as excellent / good / fair/ elementary) Languages / Dialects : Proficiency in Speaking : Proficiency in Writing : (name of referral) Career History (start with present employment) Name of Employer / Type of Business Position / Reporting To Employment Date (mm/yy) From To Monthly Salary (S$) Start End/Current Bonus AWS (Mths) (Mths) Education / Professional Qualification (from secondary school onwards) Highest Qualification Attained Specialisation (include Scholarship / Merit Award) (eg. Accountancy) Year of Award School / College / University Name Country Present Membership of Professional Bodies, Social and Sports Organisations Name of Professional Bodies/Organisation Hobbies / Interests Type of Membership Period of Membership Other Work Information Industries Preference (please rank / list, actual allocation may differ) Financial Services Investment Management Real Estate Government & Infrastructure Oil & Gas Retail & Consumer InfoComm Pharmaceutical & Healthcare Technology Insurance Private Equity Transportation & Logistics Industry Experience (where relevant) Professional Competencies Other Personal Information 1. Have you ever applied for a job with PwC? Yes No Yes No If yes, please specify Yes No Have you or are you suffering from any ailment, physical impairment/disease, mental disorder or chronic illness? Yes No Yes No Yes No Yes No Yes No If yes, please state date, position applied and outcome 2. Have you ever worked in PwC? If yes, please state period, position and Business Unit Attached to 3. 4. Do you know or related to anyone working in PwC? If yes, please specify 5. Has any member of your family been treated or is still receiving treatment for contagious disease? (eg. Tuberculosis, HIV etc) If yes, please specify 6. Have you ever been served with a notice of bankruptcy, made or discharged as a bankrupt? If yes, please specify 7. Have you ever been convicted an offence by a court of law in any country? If yes, please specify 8. Have you ever been dismissed from a job? If yes, please specify Additional Information (any additional information you wish to provide to support your application) Period of Notice to Present Employer: Expected Salary : References Employment References from Present and Past Employment (for Past 5 Years) 1. 2. Name of Referee (Ms/Mrs/Mr/Madam/Dr) Position: Company: Office Telephone No: Address: Email: Name of Referee (Ms/Mrs/Mr/Madam/Dr) Position: Company: Office Telephone No: Address: Email: Personal Reference (non-relative) 1. Name of Referee (Ms/Mrs/Mr/Madam/Dr) Occupation: Address Office Telephone No: Email: Independence and Objectivity By serving as auditors of financial statements and providing other types of professional services, PwC, its partners and staff commit themselves to professional standards of objectivity, integrity and independence. Partners and staff should conduct their business and personal affairs so as to avoid the impairment, or even the appearance of impairment, of the objectivity of PwC professional work. In this regard, the PwC Singapore Independence Policy sets out restrictions for partners and staff in the areas of individual financial interests as well as personal and business relationships. All partners and staff should take steps to ensure that their independence is maintained at all times (including disposing of restricted financial interests or exiting from conflicting relationships where necessary). Privacy Statement The personal data collected in this application form will be used by PwC to assess your suitability to assume job duties of the position for which you have applied and to determine preliminary remuneration, bonus payment and benefits package to be discussed with you subject to selection for the position. Personal data on the application form are regarded as mandatory for selection purposes. Failure to provide these data may influence the processing and outcome of your application. In the event of an unsuccessful application, we will retain your personal data for future recruitment purposes. When there are vacancies in our associate firms during that period we may transfer your application to them for consideration of employment. Personal data will be kept for only as long as it is reasonably necessary for the purposes as described above. Should you in future wish to have access to and to request for correction of your personal data in relation to your application, please contact PwC’s Human Resources Department by emailing to hr.recruit@sg.pwc.com. In the event that you have any concern or issue over the processing of your data by the firm, you can write to the Director of Human Resources, advising the specific issue/area of concern. The Director of Human Resources will look into this concern raised and assist to resolve the concern. Other Declaration I understand that Section 59 in the Accountants Act (Cap. 2) does not allow an accounting corporation, an accounting firm or an accounting LLP to employ or remunerate any person who (a) is an un-discharge bankrupt; or (b) has had his registration as a public accountant suspended or cancelled under Part V or Part VI of the Accountants Act; or (c) has been convicted of an offence by a court of law and sentenced to imprisonment for a term of not less than twelve (12) months or to a fine not less than S$5,000/-. I confirm that I am not an un-discharged bankrupt; I have not had my registration as a public accountant suspended or cancelled under Part V or Part VI of the Accountant Act (if applicable); and I have not been so charged or convicted in a court of low and if employed, undertake to inform PwC immediately with full details should I so be served with a notice of bankruptcy, made or discharged as a bankrupt, had my registration as a public accountant so suspended or cancelled (if applicable); or convicted in a court of law with similar or lesser sentence. I hereby declare that the information given by me in this application form, my resume and any other document that I provide to PwC in connection with my application for employment and my personal interviews is correct, complete and true to the best of my knowledge and belief, and that I have not wilfully suppressed any facts. I fully understand and accept that if any time after employment, it is found that a false declaration has been made in this form or that I have not complied with the terms and conditions of my employment, PwC has the absolute right to terminate my employment forthwith without assigning any reasons. I confirm that I am providing permission for PwC and its representatives to contact any of the schools, professional bodies or references I have listed above to verify the information I have given in this application. Signature : Name : Date: