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Start Date of
Internship
End Date of
Internship
Duration of
Internship
Email
Gender Age
IC Number
i. Bahasa Melayu i
i. Ba
hasa Inggeris iii. Matematik
Current Semester
Current Year of
Study
Current Class/ CGPA Graduation Ye
ar
Telephone Number
Yes No
Name
Signature Date
Met Criteria
Did Not Meet Criteria Signature :
Informed Department Name :
Memo Issued Date :
FOR OFFICIAL USE BY STRATEGIC HUMAN CAPITAL DEPARTMENT
a) Previous BNM internship experience
b) BNM
scholarship recipient
c) BNM Staff Dependant/ Family Members
I declare that all particulars submitted here are true and that I have not wilfully suppressed any material fact pertinent in determining my application and hereby consent to the
processing of my personal data by Bank Negara Malaysia in accordance with the Personal Data Protection Act 2010.
I have not been convicted in any court of law nor am I waiting to be prosecuted under the provision of any written law.
I am not currently suffering from any disability or serious/chronic illness
MY DECLARATION (Please Tick)
Name
Address
Item
FACULTY/ DEAN CONTACT INFORMATION
STRATEGIC HUMAN CAPITAL DEPARTMENT (JMIS)
INTERNSHIP APPLICATION FORM
Please ensure that all details have been completed (including photo) before submitting to JMIS.
We encourage enclosures detailing involvement in projects and elaboration of roles/ job function.
Preferred Departments
3rd
Major
Specific Area of Interest
Please state 3 Internship Objectives:
Why are you interested in an internship
at BNM, and what do you hope to gain
from the experience?
Name
Mobile no.
Mailing Address
Sijil Pelaj
aran Malaysia (SPM) Results
Course
APPLICANT'S INFORMATION
2nd
Remarks
(i.e. start and end date of previous internship/relationship with BNM staff)
Photo
OTHER INFORMATION (To tick which ever relevant)
University
1st
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Completed 25 July 2021

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