BUMITECH GLOBAL ENERGY SDN BHD ( 781730-D )

No.7, PT 186 TKT 1, PUSAT NIAGA PAKA,

23100 PAKA, DUNGUN, TERENGGANU DARUL IMAN.
TEL: 09-8279231/32 FAX : 09-8279230 EMAIL: info@bumitech.org

APPLICATION FOR CONTRACT EMPLOYMENT FORM

Name as per NRIC :

New IC No :
Contact Address :

Contact No : (Home) : (H/P) :

Email :
Nationality :
Marital Status : Single Married Others
Race / Religion :
A/C Maybank No :
Emergency Use :-
Name :
Contact No. :
Relationship :

Size : Coverall : Jacket :

I declare that the information given above is true and correct. Any information found to be false or being
withheld may lead to immediate termination of agreement or contract that I may have with the company

____________________ _________________
Signature Date