Fillable BORANG PENDAFTARAN PEKERJA ASING (FOREIGN WORKER REGISTRATION FORM)

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BORANG PENDAFTARAN PEKERJA ASING (FOREIGN WORKER REGISTRATION FORM)

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(1070797-A) .
LOT 26, UTAMA ZONE 3 COMMERCIAL,
MILE 6, LABUK ROAD,
90000 SANDAKAN, SABAH, MALAYSIA
BORANG PENDAFTARAN PEKERJA ASING
(FOREIGN WORKER REGISTRATION FORM)
NAMA PEKERJA
(NAME OF WORKER)
:
JANTINA (GENDER)
:
TARIKH LAHIR :
(DATE OF BIRTH)
NO. PASPORT
(PASSPORT NO.)
:
NEGARA ASAL :
(COUNTRY OF ORIGIN)
SEKTOR PEKERJAAN
(JOB SECTOR)
:
NAMA MAJIKAN
(EMPLOYER’S NAME)
:
ALAMAT MAJIKAN
(EMPLOYER’S ADDRESS)
:
DAERAH (DISTRICT)
:
POSKOD (POST CODE) :
NO. MYKAD/SYARIKAT
(MYKAD/COMPANY NO.)
:
NO. TELEFON :
(TELEPHONE NO.)
JIKA SYARIKAT, SILA ISIKAN MAKLUMAT ORANG YANG BERTANGGUNG JAWAB KEPADA PEKERJA ASING INI.
(IF COMPANY, PLEASE FILL IN THE PARTICULARS OF THE PERSON-IN-CHARGE FOR THIS FOREIGN WORKER)
NAMA (NAME)
:
NO. H/P (H/P NO.)
:
E-MAIL :
KLINIK YG DIPILIH
(SELECTED CLINIC)
:
JIKA LAIN NEGARA (IF OTHER COUNTRY)
SAYA BERSETUJU BAHAWA MAKLUMAT YANG DIBERIKAN DI ATAS ADALAH BENAR DAN SAYA AKAN
MEMATUHI TERMA DAN SYARAT SARINGAN KESIHATAN PEKERJA ASING TEGUH NIAGAMAJU SDN. BHD.
I AGREE THAT THE INFORMATION GIVEN ABOVE IS CORRECT AND I WILL COMPLY WITH THE TERMS AND
CONDITION OF THE FOREIGN WORKER MEDICAL EXAMINATON OF TEGUH NIAGAMAJU SDN. BHD.
PENGAKUAN (DECLARATION)
dd-mmm-yyyy (01-Jan-2020)
LELAKI / MALE
PERLADANGAN / PLANTATION
INDONESIA
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BORANG PENDAFTARAN PEKERJA ASING (FOREIGN WORKER REGISTRATION FORM)

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Completed 25 March 2021

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