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Application Form For Temporary Appointments

This is a 3 sentence summary of the document: The document is an application form for temporary appointments at Temasek Polytechnic, which requests personal details such as name, address, education history, and work experience from applicant Jerome Lua. The form notes that false information could result in disqualification or dismissal, and requires the applicant to declare that all information provided is true. Jerome Lua is currently a student at Temasek Polytechnic studying engineering and is applying to work temporarily after exams.

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Jerome
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84 views

Application Form For Temporary Appointments

This is a 3 sentence summary of the document: The document is an application form for temporary appointments at Temasek Polytechnic, which requests personal details such as name, address, education history, and work experience from applicant Jerome Lua. The form notes that false information could result in disqualification or dismissal, and requires the applicant to declare that all information provided is true. Jerome Lua is currently a student at Temasek Polytechnic studying engineering and is applying to work temporarily after exams.

Uploaded by

Jerome
Copyright
© © All Rights Reserved
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
You are on page 1/ 2

TEMASEK POLYTECHNIC

HUMAN RESOURCE & STAFF DEVELOPMENT


Application Form For Temporary Appointments

1) This form requires about 15 minutes to complete.


2) You will need to have the following supporting documents to complete this form:
- NRIC (for Singaporean); Passport (for Non-Singapore Citizen)
- Educational Certificate(s) and Transcript(s)
Important Notes
1.

False particulars or wilful suppression of material facts will render you liable to disqualification, or if appointed, to dismissal and / or appropriate legal proceedings.

2.

Please attach a copy of highest educational qualification attained.

Name (As in Identity Card or Passport)

Marital Status : Single / Married / Separated / Divorced / Widowed *

Dr / Mr / Mrs / Mdm / Miss* :

Sex :

JEROME LUA ZHI QIN

F / M*

Race : CHINESE

Date of Birth : 2/21/1992


Address :

BLK 850 YISHUN ST 81 #06-108 S760850

Contact No(s) :

67540951

Age :

Country of Birth (if Malaysia, please indicate the State) :

(Home)

Singapore Citizen

96199206

(Handphone)

21
SINGAPORE

[email protected]

Date Granted Citizenship (if applicable):

NRIC No:

Religion : CHRISTIAN

(Email Address)

Previous Nationality (if applicable) :

S9207872H

Non-Singapore Citizen

Singapore PR :

Yes / No *

Passport No :

Date of Issue :

If Yes, Date Granted SPR :

Place of Issue :

Date of Expiry :

UIN No :

FIN No :

Malaysia NRIC No :

Period available to commit to the temporary job :

Immediately after exams

to

(dd / mm / yy)

(dd / mm / yy)

Education : It is important to enclose copies of your education certificate(s) or certified statement(s) giving the detailed results of the examination you have taken.
Please attach the relevant transcripts.

Name of Schools / Institutions / Colleges / Universities

Certificate / Diploma / Degree

Date Started
(dd/mm/yy)

Date Ended
(dd/mm/yy)

PRESBYTERIAN HIGH SCHOOL

GCE O LEVELS

2004

2009

If Student from Temasek Polytechnic, please indicate which School and Class you are currently with :
School :

ENGINEERING (MTN)

Class :

M1001

Year :

2013

Answer the following questions by ticking () the Yes or No in the right hand margin. Where the answers are Yes give details below. If space is insufficient, please
use separate sheet of paper and attach to this application.
(i)

Have you ever suffered or are you suffering from any pulmonary, nervous or mental trouble, previous prolonged ill-health neurasthenia

Yes

No

or impediment in speech, hearing etc. ?


(ii)

Have you ever undergone any surgical operation or x-ray/medical investigation not of a routine nature?

(iii)

Are you currently receiving or have you received any psychiatric treatment?

(iv)

Do you have a criminal record in Singapore?

(v)

Have you ever been convicted in a court of law in any other country (excluding parking offences or criminal records disclosed above)?

(vi)

Have you ever been dismissed or suspended from any employment?

(vii)

Are you at present in debt?

(viii

Have you any obligations under promissory notes either as principal or surety?

Details on (i), (ii), (iii), (iv), (v), (vi), (vii) and/or (viii). Please provide details on a separate sheet if insufficient space.

Declaration : I declare that the above statements and information on the attached sheet(s) are true to the best of my knowledge and belief, and that I have not
wilfully suppressed any material fact, failing which I may be dismissed even if appointed.
JEROME LUA
Name & Signature of Applicant
FOR OFFICIAL USE

2/6/2013
Date

Assigned Employee No :

To : Director / FNA

Date of Application for Employment Pass / Work Permit (if applicable) :

The above temporary staff member or student helper will commence work in
Rate of pay is $

per hour / day / month*.

from

HRO's Signature & Date

* Delete where not applicable

to

(Sch/Dept)

Director / HRSD's Signature & Date

Page 1

333836556.xls

TEMASEK POLYTECHNIC

HUMAN RESOURCE & STAFF DEVELOPMENT


Application Form For Temporary Appointments

Detailed results of GCE 'N' and/or 'O' level or equivalent

Detailed results of GCE 'A' or equivalent

School attended :

PRESBYTERIAN HIGH SCHOOL

Junior College or School attended :

Year of completion:

2009

Year of completion:

Subjects

Grades

Level

Subjects

Grades

Level

ENGLISH LANGUAGE

B4

O LEVELS

A / O*

CHINESE

B3

O LEVELS

A / O*

COMBINED HUMANITIES

A1

O LEVELS

A / O*

SCIENCE (PHYSICS/CHEMISTRY)

A2

O LEVELS

A / O*

MATHEMATICS

B3

O LEVELS

A / O*

ADDITIONAL MATHEMATICS

C6

O LEVELS

A / O*

N / O / others* :

A / O*

N / O / others* :

A / O*

N / O / others* :

A / O*

Number of 'N' or "O' level passes

Present/ Last Employment & Remuneration


Name of Employer

Position Held, Brief Description of Duties & Responsibilities

Date Commenced
(dd/mm/yy)

Date Ended
(dd/mm/yy)

The Connoisseur Concerto

Service Crew, taking and serving customers' orders

Oct-11

Dec-11

Monthly Total Salary :

S$ 800

Expected Salary

S$

Past Work Experience (in chronological order) : Please attach a detailed resume if the space below is insufficient.
Name of Employer

Position Held, Brief Description of Duties & Responsibilities

Date Commenced
(dd/mm/yy)

Date Ended
(dd/mm/yy)

Flow Equipment

Admin Assistant, organising of relevant documents, sending out invoices and


quotations

Oct-10

Dec-10

Zara

Sales Executives, promote and attend to customers

Oct-09

Dec-09

Details of Active National Service : Full-time / Part-time ( SAF / RSAF / RSN / SJCD / Others ) / Exempted *
Date Enlisted :

Date Released :

Awaiting enlisting
Total Year Served :

Knowledge of Languages & Dialects


Spoken & Written :
Spoken only:

English and Chinese

English, Chinese and Hokkien

Sports, ECA, Special Interest or Hobbies


Sports/ Games (Please inidcate "Recreational" or "Competitive" at inter-class/School/National etc)

Floorball - External Floorball Club (Competitive)


ECA/ Hobbies ( Please indicate position held, if applicable)

Please provide details of any relatives / friends either working or studying in Temasek Polytechnic, if applicable.
Name

Department / School

Staff / Student

Relationship

Updated on May 2006

* Delete where not applicable

Page 2

333836556.xls

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