EMPLOYMENT RECORD APPLICATION FOR EMPLOYMENT NAME OF PRESENT EMPLOYER COMPANY : Freescale Semiconductor Malaysia Sdn Bhd (12631D) NXP Malaysia Sdn Bhd | Reg No : 197201001019 (12632D) DATE STARTED (MTH/YR) : DATE LEFT (MTH/YR) : PROFESSIONAL/SOCIAL NETWORKS CAREER FAIR REFERRAL, REFERRED BY FREESCALE WEBSITE JOBSTREET OR OTHER JOB BOARD PRESENT BASIC SALARY : RM $ RM $ PER MTH EMPLOYER BEFORE THAT : DATE STARTED (MTH/YR) : DATE LEFT (MTH/YR) : I/C NO (NEW): CITIZENSHIP : PASPORT NO. : MALAYSIAN COLOR : OTHER (NON-MALAYSIAN) EMAIL ADDRESS PER MTH SUPERVISOR'S NAME AND PHONE NO : EMPLOYER'S COMPANY'S ADDRESS AND PHONE NO : BASIC SALARY AT START : PRESENT BASIC SALARY : RM $ RM $ PER MTH REASONS FOR LEAVING : TEL NO (H) : TEL NO (H/P) : EMPLOYER BEFORE THAT : TYPE OF BUSINESS : JOB POSITION : PER MTH SUPERVISOR'S NAME AND PHONE NO : EMPLOYER'S COMPANY'S ADDRES S AND PHONE NO : TYPE OF BUSINESS : (FULL ADDRESS WITH POSTCODE): DATE STARTED (MTH/YR) : DATE LEFT (MTH/YR) : (FULL ADDRESS WITH POSTCODE): BASIC SALARY AT START : PRESENT BASIC SALARY : RM $ RM $ PER MTH REASONS FOR LEAVING : WORK AT MOTOROLA/FREESCALE/NXP BEFORE? : WHICH SITE/LOCATION? : YES JOB POSITION : OTHERS. PLEASE SPECIFY FULL NAME (AS SHOWN ON I/C): CURRENT ADDRESS BASIC SALARY AT START : REASONS FOR LEAVING : PERSONAL DATA PERMANENT ADDRESS TYPE OF BUSINESS : PASSPORT SIZE PHOTO HERE (COLORED) POSITION APPLIED : HOW YOU KNOW ABOUT THIS JOB : CHOICES : ADVERTISEMENT : EMPLOYER'S COMPANY'S ADDRESS AND PHONE NO : NO LAST YEAR WORK : CID# : NAME OF PERSON TO NOTIFY IN CASE OF EMERGENCY : 1 2 PHONE NUMBER : Have you been found guilty in any COURT OF LAW or detained under any written laws? NO (if Yes, please give details) Are you bonded by any government/corporate scholarship? YES PHONE NO : RELATIONSHIP : NAME AND ADDRESS OF SCHOOL CERT / DIP / DEGREE (STUDY MAJOR) NO (if Yes, please give details) EXPECTED SALARY : EDUCATION RECORD TYPE OF SCHOOL SUPERVISOR'S NAME AND PHONE NO : OTHER INFORMATION YES FRIENDS OR RELATIVES NAME WORKING AT FREESCALE/NXP : PER MTH POSITION HELD : RELATIONSHIP : ADDRESS (FULL ADDRESS WITH POSTCODE): JOB POSITION : ATTENDED DATE FROM - TO ACQUIRED DATE (mm/yy) (as shown on certificate) (dd/mm/yy) 1. NOTICE PERIOD : DATE AVAILABLE FOR EMPLOYMENT : REFERENCES : LIST 2 (TWO) CHARACTER & WORK RELATED INFORMATION REFERENCES : NAME ADDRESS TEL. NO. POSITION 1 SECONDARY 2. 1. COLLEGE / UNIVERSITY PROFESSIONAL QUALIFICATION 2 INSTRUCTIONS: 2. I HEREBY DECLARE THAT ALL INFORMATION PROVIDED IS TRUE. I UNDERSTAND THAT IN THE EVENT THAT ANY OF THE ABOVE STATEMENT IS FOUND TO BE UNTRUE, I AM LIABLE FOR IMMEDIATE DISMISSAL. 1. 2. ARE YOU CURRENTLY A STUDENT: LANGUAGE SPOKEN : ENGLISH MALAY PLEASE REVIEW YOUR APPLICATION. ANSWER ALL PERTINENT QUESTIONS COMPLETELY. A COMPLETED APPLICATION IS NECESSARY TO QUALIFY FOR EMPLOYMENT. READ THE FOLLOWING STATEMENT AND BE SURE TO SIGN YOUR NAME AND DATE BELOW. CHINESE OTHER CHINESE OTHER YES I UNDERSTAND AND AGREE THAT MY PERSONAL DATA, INCLUDING SENSITIVE PERSONAL DATA, MAY BE USED FOR ALL HUMAN CAPITAL RELATED PURPOSES IN ORDER FOR THE COMPANY TO CONSIDER MAKING AN OFFER OF EMPLOYMENT TO ME. I FURTHER UNDERSTAND AND AGREE THAT MY PERSONAL DATA, INCLUDING SENSITIVE PERSONAL DATA, MAY BE DISCLOSED TO THIRD PARTIES TO VERIFY AND/OR OBTAIN ADDITIONAL INFORMATION INCLUDING EDUCATION, INSTITUTIONS, CURRENT/PREVIOUS EMPLOYERS AND CREDIT REFERENCE AGENCIES. NO LANGUAGE WRITTEN : ENGLISH MALAY DATE : IDL Revision 1.7 – 2015 Malaysia IDL Revision 1.7 – 2015 Malaysia Page 1 of 2 SIGNATURE : Page 2 of 2