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Green Card Cidb Registry Form

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Green Card Cidb Registry Form
Lembaga Pembangunan Industri Pembinaan Malaysia
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

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