Jumper form20190619
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Dokumen ini adalah borang permohonan untuk program keusahawanan 'jumper punb' yang mengumpulkan maklumat peribadi pemohon termasuk latar belakang, pekerjaan, pengalaman berniaga, dan pilihan program yang ingin disertai. Pemohon dikehendaki memberikan maklumat lengkap termasuk status kesihatan dan pendidikan mereka. Selain itu, terdapat perakuan yang menegaskan bahawa maklumat yang diberikan adalah benar dan boleh disahkan oleh pihak berkenaan.
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- 1. Untuk Kegunaan Pejabat : Cop Penerimaan: PK1 PK4 PK2 PK5 PK3 No. Ruj: A) Latar Belakang Diri B) Butiran Selanjutnya Nama Penuh : Status Pekerjaan Sekarang : Bekerja Berniaga Bekerja Sendiri Tidak Bekerja No. K/P (Baru) : - - Jika bekerja ; Syarikat : Jantina : Lelaki Perempuan Industri : Jawatan : Bangsa : Melayu Bumiputera Tempoh Masa : Kaum : Notis Berhenti : Jika berniaga ; Agama : Perniagaan : Industri : Status Perkahwinan : Tempoh Masa : Bujang Berkahwin Ibu/Bapa Tunggal Jenis : Premis Bergerak Online Pengalaman Berniaga : Alamat Kediaman : Status Kesihatan/Fizikal : Sihat Sakit Ringan Sakit Kritikal Sila jelaskan (sekiranya sakit): ____________________ Poskod : Bukan OKU OKU Sila jelaskan (sekiranya OKU) : ____________________ Bandar : Hamil Tidak Hamil Negeri : Sila nyatakan minggu ke berapa (sekiranya hamil): _________ No.Tel Rumah : - C) Latar Belakang Pemohon (Sila isi ruangan mengikut status semasa) No.Tel Bimbit : - Latar Belakang Keluarga Status Pekerjaan (Bapa/Suami) : Alamat Emel : Bekerja Tidak Bekerja Bekerja Sendiri Berniaga Pesara Kelayakan Akademik : Sijil Kemahiran Tahap > 2 Diploma Status Pekerjaan (Ibu/Isteri) : Sarjana Muda Sarjana Bekerja Tidak Bekerja Bekerja Sendiri Berniaga Pesara Institut Pengajian : Pendapatan Isi Rumah : Bidang : < RM 1000 > RM 1001 - RM 1500 > RM 1501 - RM 2500 > RM 2501 - RM 3500 Tarikh Graduasi : Bulan Tahun > RM 3501 ke atas (Contoh: Apr) Sila nyatakan bilangan CGPA : Bil. Adik Beradik/Anak: Bekerja Bersekolah Gambar Borang Permohonan PROGRAM JUMPER 'START UP' PUNB Perniagaan Jawatan Tempoh SPP01-2019
- 2. Jika bekerja (Pasangan) ; E) Dari mana anda ketahui tentang Program Syarikat : JUMPER PUNB Industri : Sila pilih satu saluran yang anda gunakan untuk mengetahui Jawatan : tentang Program JUMPER PUNB Jika berniaga (Pasangan) ; Radio Laman Portal PUNB Perniagaan : Televisyen Usahawan PUNB Industri : Majalah Bank Jenis : Premis Bergerak Online Poster Agensi Kerajaan Akhbar Kawan-kawan D) Pilihan Program Keusahawanan Media Sosial Lain-lain Sila Pilih Dua (2) Program Sahaja (1 Paling Utama) : Sila nyatakan: Sila nyatakan: (Pilihan adalah bergantung kepada kekosongan) PK1) Program Keusahawanan Tekno & Khidmat Kreatif F) Perakuan Pemohon : PK2) Program Keusahawanan Kemahiran "Saya mengaku bahawa maklumat yang diberikan adalah Kejuruteraan / Pembekalan Bahan Binaan benar. Pihak PUNB berhak menolak permohonan atau/ dan membatalkan tawaran pada bila-bila masa sekiranya PK3) Program Keusahawanan Fesyen keterangan yang saya kemukakan adalah tidak benar. Saya juga memberi kuasa kepada pihak PUNB untuk PK4) Program Keusahawanan Pembekalan Barangan mendapatkan pengesahan daripada mana-mana sumber Am yang difikirkan benar". PK5) Program Keusahawanan Makanan & Minuman Pihak PUNB tidak akan dipertanggungjawabkan sekiranya berlaku kesilapan dan kesalahan semasa mengisi borang PK6) Program Keusahawanan Khidmat Pendidikan ini. PK7) Program Keusahawanan Bengkel Motokar & Motorsikal Pilihan Negeri Menjalani Perantisan: Sila pilih (2) negeri sahaja (1 Paling Utama) : Nama : Johor Pulau Pinang Melaka Kedah Tarikh : Negeri Sembilan Perlis Selangor Kelantan Sila hantar permohonan yang lengkap bersama salinan W.P Kuala Lumpur Terengganu MyKad, resume, dan salinan sijil akademik tertinggi W.P Putrajaya Pahang kepada: Perak Sarawak Sabah Sekretariat Program JUMPER PUNB Perbadanan Usahawan Nasional Berhad (PUNB) Tingkat 10, Blok 1B, Plaza Sentral, Jalan Stesen Sentral 5, Kuala Lumpur Sentral, 50470 Kuala Lumpur Tel: 03-27851908/1413/1417 Fax: 03-27802109 Tandatangan Pemohon