Job Application Form Page 3
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3CHARACTER REFEREES
Name two persons (Relatives should not be included), their addresses, telephone numbers, occupations and the period each have known
you. In the case of fresh graduates applying for the post of Science Educator (Life Sciences / Physical Sciences/ Technology & Creativity),
they should submit the name of an Academic Instructor from the College / University as one of the character referees.
Name
Name
Address
Tel No.
Address
Tel No.
Employer
Occupation
Employer
Occupation
Email Add.
Year(s) Known
Email Add.
Year(s) Known
GENERAL INFORMATION
1.
Have you been or are you suffering from any physical impairment or disease?
Yes
No
1
2.
Do you have a criminal record
in Singapore?
Yes
No
3.
Have you ever been convicted in a court of law in any other country?
Yes
No
4.
Have you ever been discharged or dismissed from the service of the Singapore
Yes
No
Government or of any Statutory Board in Singapore?
5.
Have you ever resigned from the service of the Singapore Government or of any
Yes
No
Statutory Board in Singapore?
6.
Are you an undischarged bankrupt?
Yes
No
Details, if any, of physical impairment, disease, conviction, discharge, dismissal, resignation or bankruptcy, with regard to the
preceeding section.
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
1
By this, we refer to a criminal record of a conviction under the Registration of Criminal Act.
I declare that the particulars in this application and the attachments (if any) are true and correct to the best of my knowledge and belief,
and I have not wilfully suppressed any material fact.
I understand that if I am employed, I shall be liable to dismissal if I am found to have given false, evasive or misleading statements in this
application form.
Should my application for employment be accepted by the Company, I hereby declare that I shall at all times observe the Company’s rules
and regulations and obey all instructions given by the Company.
____________________________________
____________________
Signature
Date
FOR OFFICIAL USE ONLY
The interviewing panel’s recommendation(s) is/are:
Offer
KIV
Not shortlisted, Reason: __________________
Recommended for other position
WITNESSED BY:
_________________________
________________________
_____________________
________________
NAME
DESIGNATION
SIGNATURE
DATE
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