CONSTRUCTION INDUSTRY DEVELOPMENT BOARD
Ibu Pejabat CIDB, Tingkat 7, Grand Seasons Avenue, No 72, Jalan Pahang, 53000 Kuala Lumpur Tel 03 2617 0200, Faks: 03 4043 0801
UPP 1
Pin.2/2008
FORM IS GIVEN FOR FREE
PHOTO Please paste one recent i.c. size colour photograph with glue. Do not use stapler/cut the photo. PHOTO MUST BE SHARP & CLEAN
CONSTRUCTION PERSONNEL REGISTRATION FORM
The Construction Personnel Registration Programme is based to Pekeliling Program Kad Hijau CIDB Bil.1/2000 dan Bil.1/2001. General instruction: - This Form is to be read together with Construction Personnel Registration Requirements & Procedures.
http:/www.cidb.gov.my
NEW REGISTRATION
RENEWAL
Please √ where applicable. For renewal, information for A, F & G are necessary to fill-up. Please enclose the certified documents as instructed.
A. APPLICANT'S INFORMATION
(Enclose copy of certified i.c) Full name: (With capital letter as in i.c/passport) New i.c. no:
CIDB Registration Card No: Date of birth: Old i.c. no:
Nationality:
EXTRA INFORMATIONS TO BE FILLED-UP BY FOREIGN WORKER
Passport no: Work permit expiry date: Race: Sex: Male Female Marital status: Religion: Single Married Divorcee/Widow/Widower
(Enclose copy of passport with valid work permit certified by employer as appear on work permit) Correspondence address:
Permanent address if different:
Postcode Tel. no.: Primary SRP/LCE /PMR Construction Worker Mobile tel. no.: SPM /MCE Skilled Construction Worker
Postcode
B. ACADEMIC/SKILL QUALIFICATION C. INFORMATION OF OCCUPATION
General Worker
(Enclose copy of Technical Cerificate (marked **) if any) Polytechnic** Diploma** SKM**/ Degree** SPVM** Construction Site Supervisor Assistant Construction Manager 30-39 500-749 Construction Site Manager Construction Trainee
Others (please specify) Master** Degree Administrative Personnel Doctor of ** Phylosophy Others (please specify)
Income in daily/monthly: daily monthly
Amount of