Employment Application Form

1.Please write in capital letters.
2.No space should be left blank. If it's not applicable, write NA or NIL.
3.Please produce as copies of NRIC, certificates, resume, testimonials and latest salary slips should be attached to the form.

Application Date
:
Position Applied
:
Customer Service Professional Telemarketer Internship Support Role


How did you come to know of this vacancy?
**For personal recommendation, kindly indicate the full name of the introducer


Personal Information

Full Name (as in IC)
:
IC No
:
YYMMDD-XX-XXXX
Passport
:
Passport Only
Telephone Number
:
Mobile phone
:
Email Address
:
Current Address
:
Postcode
:
Nationality
:
Place of Birth
:
Date of Birth
:
MM/DD/YYYY
Age
:
Marital Status
:
Single Married
No. of Children
:
Religion
:
Criminal Record
:
Yes No
Who should we contact in an emergency. (Next of kin, preferably family members (For contact in case of emergency)
Name
:
Relationship
:
Contact No
:
Availability
Available Date
:
Last salary
:
Expected Salary
:

Education & Qualification

Date (Month/Year) Name of Institute Qualification Grade/CGPA
SPM Qualification Result
Bahasa MalaysiaEnglishMathametics
 Reference:
Grade1 - 67 - 89
Result Credit Pass Failed

Languages (Spoken and Written)

Spoken
English
:
Malay
:
Mandarin
:
Cantonese
:
Tamil
:
Tagalog
:
Japanese
:
Bangladeshi
:
Others
:
Written
English
:
Malay
:
Mandarin
:
Cantonese
:
Tamil
:
Tagalog
:
Japanese
:
Bangladeshi
:
Others
:

Employment Detail

List most recent job first.
From-To (Month/Year) Company Name & Address Job Title Salary/Pay Rate Reason For Leaving
# From (Month/Year) - To (Month/Year)
1 - RM
2 - RM
3 - RM
4 - RM
5 - RM
Do you have any objection to us contacting your present employer to verify the above? Yes No

List at least two (2) referees whom we may approach for reference, preferably your superior or a Human Resources associate of your previous employment. Students or fresh graduates may include lecturers as your referees. Referees should be your former/current superior.

NamePositionEmployer/Institution Contact No.Years Known
1.
2.
3.


Equal Opportunities

SRG AP operates an equal opportunity policy where we will not discriminate against people on the grounds of their gender, marital status, age, disability, race, or nationality. SRG AP will not discriminate in advertising, selection, offering training or providing benefits and services. Vacancies will be opened equally to those with the required qualifications.

Others

1. Are you willing to travel as part of your job responsibilities? Yes No
2. Are you currently serving any employment bond (e.g., with your current employer, association, JPA, or others)? Yes No
3. Have you ever been discharged, dismissed, or asked to resign from any previous employment? Yes No
4. Have you ever been convicted of any offence, including bankruptcy, court cases, traffic violations, or criminal charges? Yes No
5. Have you applied for any positions with other organizations recently? Yes (please specify) No
6. Do you intend to pursue further studies in the near future? Yes No
7. Are you currently or have you previously been involved in any Industrial Relations cases with the Ministry of Human Resources or the Industrial Court? Yes No
8. Do you have any relatives currently working with SRG Asia Pacific Sdn Bhd? Yes No

If yes, provide:

Name :

Position :

Relationship :

9. Do you have any physical limitations or disabilities? Yes No
10. Have you undergone any major surgery or hospitalization in the past? Yes No
11. Are you currently suffering from any major illness? Yes No

If yes, please tick:

Hypertension
Migraine
Asthma
Diabetes

Other:

12. (For Female Candidates Only) Are you currently pregnant? Yes No
13. Have you previously been employed by SRG Asia Pacific Sdn Bhd? Yes No

If yes, provide:

Position Held :

From : To :

Reason for leaving :

14. Do you have an active CIMB Bank account for salary purposes? Yes No
15. Do you have any other active bank accounts? Yes No

If yes, bank name :

16. Do you have any ongoing legal obligations or restrictions that may affect your employment? Yes No

If yes, specify:

17. Have you ever been involved in any disciplinary action (verbal/written warning, suspension, etc.) at any previous workplace? Yes No

If yes, explain:

18. Do you have any secondary employment, freelance jobs, or business interests that may affect your availability or conflict with this role? Yes No

If yes, details:

19. Are you willing to undergo a background check (e.g., employment history, criminal record, reference checks) as part of the hiring process? Yes No
20. Do you understand and agree to comply with the company's Code of Conduct and Ethics once employed? Yes No
21. Do you agree to keep all company information and client data strictly confidential, both during and after your employment? Yes No
22. Are you currently a member or actively involved in any of the following organizations or associations?
Political/Parliamentary Parties
Sports Associations (state, national, or international level)
Trade Unions
Non-Governmental Organizations (NGOs)
Religious or Community-Based Organizations

Others (please specify):


If yes, please provide:

Name of Organization:

Position Held (if any):

Level of Involvement: Active Passive/Member Only


Application Referrals - (Recommend your friend to work with us!) | Please list minimum 3 person.

Application Referral Opportunity. We're currently hiring and would love your support! If you have any friends or contacts who are looking for job opportunities, feel free to refer them to us.


NameMobile No.E-mail
1.
2.
3.
4.
5.

MySejahtera Vaccination Status

MySejahteraID :


1. Vaccine Registration Status Yes No

2. First Dose? Yes No
If Yes, Please fill in Batch No
3. Second Dose? Yes No
If Yes, Please fill in Batch No

Employment Status

(Please select and tick one of the following options)

Unemployed, duration: months
Retrenchment
Fresh Graduate

Declaration Clause.

I hereby declare that the information given by me in this form is correct and true to the best of my knowledge.

I give consent to SRG Asia Pacific Sdn Bhd to process my personal data in accordance with the Personal Data Protection Notice.

I confirm that I have obtained consent from any third party whose personal data is included in this form.

I also authorize any educational institution or current/past employer to provide SRG Asia Pacific with information to verify my qualifications and experience.

I understand that if any false information is found, the company reserves the right to terminate my employment immediately.

I acknowledge and confirm that I have read, understand and accept the above clause.I acknowledge and confirm that I have read, understood, and accept the above declaration and consent clauses.