Internship Application Form

Borang Permohonan Latihan Industri

Date Applied
Tarikh Memohon

Name (Full Name as stated on IC)
Nama (Nama Penuh seperti tertera pada IC) *

IC No. / Passport No.
No. Kad Pengenalan / No. Passport *

Education Level
Taraf Pendidikan * Master PMR SPM STPM Diploma Degree Certificate

Course
Kursus *

Accounting / Perakaunan Mechatronics Engineering / Kejuruteraan Mekatronik Electrical & Electronics Engineering / Kejuruteraan Elektrik & Elektronik Biotechnology / Bioteknologi Economics / Ekonomi Business Administration / Pentadbiran Perniagaan Communication / Komunikasi Building Engineering Technology / Teknologi Kejuruteraan Bangunan Metal Fabrication Technology / Teknologi Fabrikasi Logam Graphic Design / Rekabentuk Grafik Piping Fabrication Engineering Technology / Teknologi Kejuruteraan Fabrikasi Perpaipan Structural Fabrication Engineering Technology / Teknologi Kejuruteraan Fabrikasi Struktur Material Engineering / Kejuruteraan Bahan Technology Management / Pengurusan Teknologi Architect / Pelukis Pelan Senibina Actuarial Science / Sains Aktuari Logistics / Logistik Supply Chain / Rantaian Bekalan Statistics / Statistik Mathematics / Matematik Human Resource / Sumber Manusia Packaging Engineering Technology / Teknologi Kejuruteraan Pembungkusan Health, Safety & Environment (HSE) / Kesihatan, Keselamatan & Alam Sekitar (HSE) International business / Perniagaan Antarabangsa Law Enforcement Administration / Pentadbiran Penguatkuasaan Undang-Undang Security Management / Pengurusan Keselamatan Policing & Investigation / Polisi & Siasatan Investigation Services / Perkhidmatan Penyiasat Psychology / Psikologi Chargeman / Penjaga Jentera Elektrik Voltan Rendah Chemistry / Kimia Welding Technology / Teknologi Kimpalan Industrial Machinery / Jentera Perindustrian Civil Engineering / Kejuruteraan Awam Environmental Engineering / Kejuruteraan Alam Sekitar Decision Science / Sains Keputusan English Studies / Pengajian Bahasa Inggeris Health Science / Sains Kesihatan Nutrition / Pemakanan Food Technology / Teknologi Makanan Building Maintenance / Penyelenggaraan Bangunan Manufacturing Engineering / Kejuruteraan Pembuatan Physics / Fizik Marketing / Pemasaran Operation Management / Pengurusan Operasi Social Science / Sains Sosial Real Estate Management / Pengurusan Hartanah Information Technology / Teknologi Maklumat Law / Undang-undang Industrial Ceramic / Keramik Industri Polymer Engineering / Kejuruteraan Polimer Computer Systems / Sistem Komputer Applied Sciences / Sains Gunaan Banking & Finance / Perbankan & Kewangan New Energy & Science Engineering / Kejuruteraan Tenaga & Sains Baru Chemical Engineering / Kejuruteraan Kimia Data Analytics / Analitik Data Computer Aided Design & Drafting (CADD) / Reka Bentuk & Penggubalan Berbantukan Komputer (CADD) Mechanical Engineering / Kejuruteraan Mekanikal Petroleum Engineering / Kejuruteraan Petroleum Aerospace Engineering / Kejuruteraan Aeroangkasa Bioprocess Engineering / Kejuruteraan Bioproses Biochemistry / Biokimia Biomedical Engineering / Kejuruteraan Bioperubatan Others Business Operations / Pengoperasian Perniagaan Refrigeration & Air Conditioning Technology / Teknologi Penyejukan & Penyaman Udara Electrical Installation / Pemasangan Elektrik Architectural Engineering / Kejuruteraan Senibina Printing Technology / Teknologi Percetakan Software Technology (Interactive Multimedia) / Teknologi Perisian (Multimedia Interaktif) Electrical Wiring PW2 / Pendawai Elektrik PW2 Electrician (3 Phase) (3 Phase Electrician) / Pendawai Elektrik (3 Fasa) (3 Phase Electrician) Enforcement Management / Pengurusan Penguatkuasaan

Cumulative Grade Point Average (CGPA)
Purata Nilai Gred Keseluruhan (PNGK) *

University / College
Universiti / Kolej *

Politeknik Ungku Omar (PUO) Politeknik Seberang Perai (PSP) University of Reading Malaysia Campus (UoRM) University of Southampton Malaysia Campus (USMC) Wawasan Open University (WOU) Xiamen University Malaysia Others Politeknik Melaka (PKM) Politeknik Hulu Terengganu, Terengganu (PHT) Politeknik Sultan Mizan Zainal Abidin (PSMZA) Politeknik Merlimau (PMM) Politeknik Sultan Azlan Shah (PSAS) Micro Tech TVET College Politeknik Tuanku Sultanah Bahiyah (PTSB) Politeknik Sultan Idris Shah (PSIS) Institut Kemahiran MARA (IKM) Beseri, Perlis Institut Kemahiran MARA (IKM) Sik, Kedah Institut Kemahiran MARA (IKM) Sungai Petani, Kedah Institut Kemahiran MARA (IKM) Lumut, Perak Institut Kemahiran MARA (IKM) Kuala Lumpur Institut Kemahiran MARA (IKM) Besut, Terengganu Institut Kemahiran MARA (IKM) Tan Sri Yahya Ahmad (TSYA) Pekan, Pahang Institut Kemahiran MARA (IKM) Johor Bahru Institut Kemahiran MARA (IKM) Jasin, Melaka Institut Kemahiran MARA (IKM) Kuching, Sarawak Institut Kemahiran MARA (IKM) Kota Kinabalu, Sabah Institut Kemahiran MARA (IKM) Bintulu, Sarawak Politeknik Muadzam Shah (PMS) Institut Kemahiran Tinggi Belia Negara (IKTBN) Institut Kemahiran Belia Negara (IKBN) Politeknik Balik Pulau (PBU) Politeknik Jeli (PJK) Institut Kemahiran Belia Negara (IKBN) Jitra, Kedah Institut Kemahiran Belia Negara (IKBN) Wakaf Tapai, Terengganu Institut Kemahiran Belia Negara (IKBN) Kinarut, Sabah Institut Kemahiran Belia Negara (IKBN) Miri, Sarawak Institut Kemahiran Belia Negara (IKBN) Bandar Penawar, Johor Kolej Komuniti Jasin, Melaka (KK Jasin) Kolej Komuniti Chenderoh , Perak (KK Chenderoh) Kolej Komuniti Gerik, Perak (KK Gerik) Kolej Komuniti Sungai Siput, Perak (KK Sungai Petani) Kolej Komuniti Taiping, Perak (KK Taiping) Kolej Komuniti Bagan Datuk, Perak (KK Bagan Datuk) Kolej Poly Tech MARA Politeknik Sultan Salahuddin Abdul Aziz Shah (PSA) Politeknik Mukah (PMU) Politeknik Nilai (PNS) Politeknik Banting (PBS) Politeknik Mersing (PMJ) Saito College Politeknik Kuala Terengganu (PKT) Politeknik Sandakan (PSS) Institut Kemahiran Tinggi Belia Negara (IKTBN) Chembong, Negeri Sembilan Institut Kemahiran Tinggi Belia Negara (IKTBN) Sepang, Selangor Institut Kemahiran Tinggi Belia Negara (IKTBN) Dusun Tua, Selangor Institut Kemahiran Tinggi Belia Negara (IKTBN) Bachok, Kelantan Institut Kemahiran Tinggi Belia Negara (IKTBN) Temerloh, Pahang Institut Kemahiran Tinggi Belia Negara (IKTBN) Pagoh, Johor Institut Kemahiran Tinggi Belia Negara (IKTBN) Alor Gajah, Melaka Institut Kemahiran Tinggi Belia Negara (IKTBN) Bukit Mertajam, Pulau Pinang Institut Kemahiran Belia Negara (IKBN) Naka, Kedah Institut Kemahiran Belia Negara (IKBN) Kuala Perlis, Perlis Institut Kemahiran Belia Negara (IKBN) Seri Iskandar, Perak Politeknik Tuanku Syed Sirajuddin (PTSS) Kolej Kemahiran Tinggi MARA Kuantan, Pahang Kolej Kemahiran Tinggi MARA Kemaman, Terengganu Kolej Kemahiran Tinggi MARA Pasir Mas, Kelantan Kolej Kemahiran Tinggi MARA Petaling Jaya, Selangor Kolej Kemahiran Tinggi MARA Balik Pulau, Pulau Pinang UNIKOP Politeknik Kuala Terengganu (PKKT) Politeknik Tun Syed Nasir Syed Ismail (PTSN) Politeknik Besut (PBT) ADTEC SHAH ALAM ADTEC BATU PAHAT ADTEC KULIM ADTEC TAIPING ADTEC BINTULU ADTEC JERANTUT Akademi Binaan Malaysia Wilayah Utara (ABM Kedah, Perak, Pulau Pinang dan Perlis) Akademi Binaan Malaysia Wilayah Tengah Kuala Lumpur (ABM KL) Akademi Binaan Malaysia Wilayah Selatan Johor Bahru (ABM Johor Bahru) Akademi Binaan Malaysia Wilayah Timur Terengganu (ABM Terengganu) Politeknik Ibrahim Sultan (PIS) Politeknik Bagan Datuk (PBD) Kolej Komuniti Bagan Serai, Perak (KK Bagan Serai) Kolej Komuniti Pasir Salak, Perak (KK Pasir Salak) Politeknik Tawau (PTS) Kolej Komuniti RTC Gopeng, Perak (KK RTC Gopeng) Kolej Komuniti Tapah, Perak (KK Tapah) Kolej Komuniti Segamat, Johor (KK Segamat) Kolej Komuniti Ledang, Johor (KK Ledang) Kolej Komuniti Batu Pahat, Johor (KK Batu Pahat) Kolej Komuniti Tanjung Piai, Johor (KK Tanjung Piai) Kolej Komuniti Segamat 2, Johor (KK Segamat 2) Kolej Komuniti Bandar Penawar, Johor (KK Bandar Penawar) Politeknik METrO Kuala Lumpur (PMKL) Politeknik METrO Kuantan (PMKU) Politeknik METrO Johor Bahru (PMJB) Politeknik METrO Tasek Gelugor (PMTG) Politeknik METrO Betong (PMB) Universiti Malaya (UM) Universiti Islam Antarabangsa Malaysia (IIUM) Universiti Kebangsaan Malaysia (UKM) Kolej Komuniti Rantau Panjang, Kelantan (KK Rantau Panjang) Kolej Komuniti Pasir Gudang, Johor (KK Pasir Gudang) Kolej Komuniti Bentong, Pahang (KK Bentong) Kolej Komuniti Temerloh, Pahang (KK Temerloh) Kolej Komuniti Kuantan, Pahang (KK Kuantan) Kolej Komuniti Paya Besar, Pahang (KK Paya Besar) Kolej Komuniti Rompin, Pahang (KK Rompin) Kolej Komuniti Kok Lanas, Kelantan (KK Kok Lanas) Kolej Komuniti Pasir Mas, Kelantan (KK Pasir Mas) Politeknik Sultan Haji Ahmad Shah (POLISAS), Kuantan, Pahang Universiti Malaysia Kelantan (UMK) Universiti Malaysia Pahang (UMP) Universiti Malaysia Perlis (UniMAP) Universiti Malaysia Sabah (UMS) Universiti Malaysia Sarawak (UNIMAS) Universiti Malaysia Terengganu (UMT) Universiti Pendidikan Sultan Idris (UPSI) Universiti Pertahanan Nasional Malaysia (UPNM) Universiti Putra Malaysia (UPM) Universiti Teknologi Petronas (UTP) Politeknik Sultan Abdul Halim Mu'adzam Shah (POLIMAS) Universiti Sains Islam Malaysia (USIM) Universiti Sains Malaysia (USM) Universiti Sultan Zainal Abidin (UniSZA) Universiti Teknikal Malaysia Melaka (UTeM) Universiti Teknologi Malaysia (UTM) Universiti Teknologi MARA (UiTM) Universiti Tun Hussein Onn Malaysia (UTHM) Brickfields Asia College (BAC) Universiti Utara Malaysia (UUM) Al-Madinah International University (MEDIU) Asia e University (AeU) Kolej Profesional MARA (KPM) Politeknik Kota Bharu (PKB) Asia Metropolitan University (AMU) Asia Pacific University of Technology & Innovation (APU) Binary University (Binary) City University, Malaysia (CityU) Curtin University, Malaysia (Curtin) DRB-HICOM University of Automotive Malaysia GlobalNxt University (GNU) Jelebu University of Technology & Computer Institute Malaysia (JUTKI) Heriot-Watt University Malaysia (HWUM) Infrastructure University Kuala Lumpur(IUKL) Tunku Abdul Rahman University College (TARUC) Politeknik Kuching (PKS) International Medical University (IMU) INTI International University (INTI) Limkokwing University of Creative Technology MAHSA University Malaysia University of Science and Technology (MUST) Kolej Komuniti Kepala Batas, Pulau Pinang (KK Kepala Batas) Kolej Komuniti Seberang Perai, Pulau Pinang (KK Seberang Perai) Management & Science University (MSU) Manipal International University (MIU) Monash University Malaysia Campus (Monash) Multimedia University (MMU) Kolej Komuniti Kuala Terengganu, Terengganu (KK Kuala Terengganu) Kolej Komuniti Besut, Terengganu (KK Besut) Kolej Komuniti Kemaman, Terengganu ( KK Kemaman) Kolej Komuniti Cawangan Setiu, Terengganu (KK Cawangan Setiu) Kolej Komuniti Kuching, Sarawak (KK Kuching) Kolej Komuniti Mas Gading, Sarawak (KK Mas Gading) Kolej Komuniti Sarikei, Sarawak (KK Sarikei) Kolej Komuniti Santubong, Sarawak (KK Santubong) Kolej Komuniti Betong, Sarawak (KK Betong) Kolej Komuniti Tawau, Sabah (KK Tawau) Kolej Komuniti Semporna, Sabah (KK Semporna) Kolej Komuniti Beaufort, Sabah (KK Beaufort) Kolej Komuniti Penampang, Sabah (KK Penampang) Kolej Komuniti Sandakan, Sabah (KK Sandakan) Kolej Komuniti Kota Marudu, Sabah (KK Kota Marudu) Ranaco Education And Training Institute Kolej Komuniti Kulim, Kedah (KK Kulim) Newcastle University Medicine Malaysia (NUMed) Kolej Kemahiran Tinggi MARA Sri Gading, Johor Kolej Kemahiran Tinggi Mara Ledang, Johor Kolej Kemahiran Tinggi MARA Masjid Tanah, Melaka Kolej Kemahiran Tinggi MARA Rembau, Negeri Sembilan Kolej Kemahiran Tinggi MARA Lenggong, Perak E - Access International College Politeknik Port Dickson (PPD) Nilai University Open University Malaysia (OUM) Institut Kemahiran MARA (IKM) Seberang Perai Utara Quest International University Perak (QIUP) Raffles University Iskandar (RUI) SEGi University Kolej Komuniti TECH TERRAIN COLLAGE Sunway University Swinburne University of Technology Sarawak Campus Taylor's University Tun Abdul Razak University (UNIRAZAK) UCSI University (UCSI) University College TATI Politeknik Kota Kinabalu (PKK) UNITAR International University (UNITAR) Islamic University of Malaysia (UIM) University of Kuala Lumpur (UniKL) University of Selangor (UNISEL) College MCS Sultan Abdul Halim Mu'adzam Shah International Islamic University Sultan Azlan Shah University (USAS) Universiti Tenaga Nasional (UNITEN) University Tunku Abdul Rahman (UTAR) University of Cyberjaya University Malaysia of Computer Science & Engineering (UniMy) University of Nottingham Malaysia Campus (UNMC) ADTEC KEMAMAN Kolej Komuniti Bandar Baharu Kedah (KK Bandar Baharu) Kolej Genius Klang MARA-JAPAN INDUSTRIAL INSTITUTE (MJII) Kolej Komuniti Hulu Langat, Selangor (KK Hulu Langat) Kolej Komuniti Kuala Langat, Selangor (KK Kuala Langat) Kolej Komuniti Klang, Selangor (KK Klang) Kolej Komuniti Sabak Bernam, Selangor (KK Sabak Bernam) Kolej Komuniti Ampang, Selangor (KK Ampang) Kolej Komuniti Tanjung Karang, Selangor (KK Tanjung Karang) Kolej Komuniti Jempol, Negeri Sembilan (KK Jempol) Kolej Komuniti Jelebu, Negeri Sembilan (KK Jelebu) Kolej Komuniti Bukit Beruang, Melaka (KK Bukit Beruang) Kolej Komuniti Masjid Tanah, Melaka (KK Masjid Tanah) Institut Latihan Perindustrian Ipoh, Perak (ILP Ipoh) Institut Latihan Perindustrian Kuala Lumpur (ILP KL) Institut Latihan Perindustrian Kuala Langat, Selangor (ILP Kuala Langat) Institut Latihan Perindustrian Pedas, Melaka (ILP Pedas) Institut Latihan Perindustrian Kangar, Perlis (ILP Kangar) Institut Latihan Perindustrian Bukit Katil, Melaka (ILP Bukit Katil) Institut Latihan Perindustrian Kepala Batas, Pulau Pinang (ILP Kepala Batas) Institut Latihan Perindustrian Jitra, Kedah (ILP Jitra) Institut Latihan Perindustrian Marang, Terengganu (ILP Marang) Institut Latihan Perindustrian Kuantan, Pahang (ILP Kuantan) Institut Latihan Perindustrian Nibong Tebal, Pulau Pinang (ILP Nibong Tebal) Institut Latihan Perindustrian Pasir Gudang, Johor (ILP Pasir Gudang) Institut Latihan Perindustrian Perai, Johor (ILP Perai) Institut Latihan Perindustrian Kota Bharu, Kelantan (ILP Kota Bharu) Institut Latihan Perindustrian Selandar, Melaka (ILP Selandar) Institut Latihan Perindustrian Kuala Terengganu, Terengganu (ILP Kuala Terengganu) Institut Latihan Perindustrian Miri, Sarawak (ILP Miri) Institut Latihan Perindustrian Sandakan, Sabah (ILP Sandakan) Kolej Komuniti Selandar Melaka (KK Selandar) ADTEC MELAKA Institut Teknikal Jepun Malaysia (JMTI) Sri Ayu College Kolej Vokasional Kolej Newton

Email Address
Alamat Emel *

Contact No.
No. Telefon *

Gender
Jantina * Male Female

Nationality
Warganegara *

Afghanistan Bahrain Morocco Mozambique Myanmar Namibia Nepal Netherlands New Caledonia New Zealand Nicaragua Nigeria Bangladesh Norway Oman Pakistan Palestine Panama Pap. New Guinea Paraguay Peru Philippines Poland Barbados Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saudi Arabia Senegal Serbia Belarus Sierra Leone Singapore Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Belgium Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Tonga Belize Trinidad and Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United Kingdom Uruguay USA Benin Uzbekistan Vanuatu Venezuela Vietnam Yemen Zambia Zimbabwe St Lucia Bolivia Bosnia Botswana Albania Brazil Brunei Daruss. Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Central.African.Rep Chad Algeria Chile China Colombia Costa Rica Croatia Cyprus Czech Republic Dem. Rep. Congo Denmark Djibouti Angola Dominican Rep. East Timor Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Fiji Rep. of Congo Argentina Finland France Gambia Georgia Germany Ghana Greece Guam Guatemala Guinea Armenia Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Australia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Austria Kosovo Kyrgyzstan Kuwait Laos Latvia Lebanon Liberia Libya Lithuania Macedonia Slovak Republic Azerbaijan Madagascar Malawi Malaysia Macau Maldives Mali Malta Mauritania Mauritius Mexico Mongolia Korea Antigua/Barbuda Europe Cote d'Ivoire Moldova Africa European Union

Internship Start Date
Tarikh Mula Latihan Industri *

Internship End Date
Tarikh Tamat Latihan Industri *

Applied Department
(Maximum 3)
Jabatan yang dipohon
(Maksimum 3) *

Admin Finance Safety Inventory Corporate Communication Nutritionist Graphic Designer & Video Editor Centralized Planner Gov Affairs, Project & Security Engineering Documentation Industrial Effluence Treatment System (IETS) Human Resources Information Technology Internal Audit Logistics Manufacturing Marketing Property & Business Development Quality Assurance (QA) Research & Development (R&D) Sourcing & procurement Warehouse Packaging Material Purchasing

Please State (if Other)
Sila Nyatakan (jika lain-lain) *

Weight (kg) Example: 55.4
Berat (kg) Contoh: 55.4 *

Height (m) Example: 1.62
Tinggi (m) Contoh: 1.62 *

Are you a smoker?
Adakah anda seorang perokok? *

Yes No

Resume (.pdf, .doc, .docx only)
Resume (.pdf, .doc, .docx sahaja) *

Drop files here or click to upload.

• remove

Preferred Location
Lokasi Pilihan * Meru, Klang Ipoh, Perak Kulim, Kedah Kota Bharu, Kelantan Kluang, Johor Lukut, Negeri Sembilan Nilai, Negeri Sembilan Banting, Selangor

Source
Sumber * TG Career Email Direct Email Top Glove Website Career Fair Jobstreet Referral On Campus Interview MTDC INDEED Fast Job Top Glove Virtual University Fair Social Media (Facebook) Social Media (Instagram) Social Media (Whatsapp) Top Glove Virtual TVET Fair Others The International Council of Malaysian Scholars and Associates (ICMS) Career Talk Internship FASTREK University Portal

Do you need to apply for Hostel?
Adakah anda memerlukan hostel? *

Yes No

Note / Nota :

1. Location of current home address should be 40km and above from working location
   (Lokasi tempat tinggal haruslah melebihi 40 km daripada lokasi tempat kerja Top Glove)
2. Subjects on the vacancy
   (Tertakluk kepada kekosongan)
3. Travelling distance of current home address to the working location is 45 minutes and above.
   (Jarak perjalanan dari tempat tinggal semasa ke lokasi tempat kerja Top Glove melebihi 45 minit)