Blk 130, Jurong Gateway Road #04-221, Singapore 600130 Tel: 6899 3088 Fax: 6899 9318 www.securus.com.sg
A Post B Personal C Family D Employment E NS F Education G Language H Health I Criminal J General K Declaration
Section A

Post Applied For

Enter the position applied by the applicant.
Required
Section B

Personal Data

Applicant details as stated in NRIC / official document.

Emergency Contact — person to notify in case of emergency.

Section C

Family Background

Add family members. Extra rows can be added.
RelationshipNameAgeQualificationOccupation
Section D

Employment History

Most recent employer first.
From - ToCompanyLast salaryReason for leaving
Section E

National Service

Male Singapore citizens only.

Section F

Educational Background

Add school / institution records.
School / InstitutionFromToQualification Attained
Section G

Language Proficiency

Select languages applicant can speak and write.

Section H

Health Declaration

Select Yes/No and enter details where required.
Section I

Criminal Record

Have you been screened at CID for any investigation?
Have you been convicted in the Court of Law in any country?
Section J

General Information

Have you previously applied for employment in this company?
Do you know anyone in this company?
Section K

Declaration

Applicant to sign using tablet screen.
1) I give my consent for the company to obtain and verify from or with any source, as deemed appropriate for the assessment of my application for employment.

2) I declared the particulars given by me in this application for employment and the attached sheets are true to the best of my knowledge and belief. I have not willfully suppressed any material fact. I accept that if any of the information given by me in this application is any way false or incorrect, I shall be disqualified from employment or dismissed from service.

3) To submit medical certificate certifying that I am physically healthy to perform the role (for applicants above 60 years old).

4) I will conform to the code of conduct governed by Police Licensing Regulatory Department and if I failed to do so, I understand that I will be subjected to disciplinary action which may include termination.


Photo / Attachment

Take Photo / Attach Documents

Tablet camera can be used for applicant photo and documents.
Office Use

For Official Use Only

This section remains blank in generated PDF for HR office use.

Submit Application
PDF will be generated using original Securus format and sent to HR email when SMTP is configured.