ENVO BPO SERVICES SDN BHD

APPLICATION FORM
APPLICATION FOR EMPLOYMENT
Position Applied For : TELEMARKETING EXECUTIVE Department:

SECTION A – PERSONAL PARTICULARS

Name (as per IC): FATIMAH SALIHA BT HABEEB RAHUMAN Other Name:

IC No. (New): 000603101442 Date of Birth: 03/06/2000

Place of Birth: SELANGOR Nationality: MALAYSIAN

Age: 22 Gender: FEMALE

Permanent Address: B9-01-09, BLOCK 9, DESA MENTARI Correspondence Address (if different from previous):
2, JALAN PJS 2B/1, 46000, PETALING JAYA

Tel. No: - H/Phone No: 0167555309

Race: INDIAN Religion: ISLAM

Marital Status:SINGLE Email Address: saliha362@gmail.com

SECTION B – FAMILY PARTICULARS

Spouse Name: NRIC (Old and New) :

Is your Spouse working? □ NO □ YES (if yes please provide information below

Occupation: Spouse’s Mobile No.:

Spouse’s Employer: Spouse’s Employer Address:

Children YOU are entitled to for child relief as of : (01/01/__________)

Date of Receiving Full
No. Name Age Gender Birth Cert/IC no.
Birth Time Education
1

5
Child certified by the Department of Social Welfare to be disabled
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EMERGENCY CONTACT (To be contacted in case of emergency)
No Name & Address Relationship Contact No.
1 HABEEB RAHUMAN FATHER 0129244552

SECTION C – SALARY CREDITING AND STATUTORY CONTRIBUTION / DEDUCTION

EPF NO : Income Tax No:

SOCSO NO : Bank Name: PUBLIC BANK

(NOTE: Public Bank)

BANK ACCOUNT NO: 4921294428

SECTION D – EMPLOYMENT HISTORY (Start with most current)

Employer’s Name & Year Last Drawn
No Position Held Reason For Leaving
Address From To Salary
WCD, JLN KLANG TELEMARKETING 08/2022 10/2022 End of contract 3 RM 2500
1
LAMA EXEC months
ENVO BPO TELEMARKETING 07/2022 09/2022 Offers part time job RM 1800
2
EXEC at different place
Astro, uoa business park TELEMARKETING 05/2021 05/2022 Resign to continue RM 2000
3
EXEC degree
4 TADIKA SRI BETHANY TEACHER 02/2021 04/2021 LOCATION SHIFT RM 1500

SK SRI KELANA TEACHER 09/2020 11/2020 NEED TO HAVE RM 1600

DEGREE FOR
5
PERMANENT
STAFF
6

Current Expected
Basic Salary

Allowance/Other Benefits
Notice Period: Possess Own Transport: Yes / No Preferred Job Type(s):
□ Full-Time
Earliest Availability: Preferred Work Location: pj □ Contract: Part-time (Duration)
Are you willing to
work on shift : Yes / No

SECTION E – REFERENCES (Please provide one personal and one previous employer)
No of Years
No Name Address Contact No.
Known
MS. AMY TAMAN SRI SENTOSA, KUALA 0123688703 2 YEARS
1
LUMPUR
2 MRS. ZAKIAH JALAN SS7, KELANA JAYA 0133866143 2 YEARS

Please provide 2 more referee names in case the above is not contactable

SECTION F – EDUCATION BACKGROUND (From highest to lowest)

Name of University / Year Grade /
No. Qualification Obtained Field of Study
College/School From To CGPA
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 UNITAR BACHELOR’S 2021 PRESE EDUCATION IN 3.8
1 INTERNATIONAL DEGREE NT ECONOMY CURRE
UNIVERSITY NT
UNITAR DIPLOMA 2018 2021 EARLY CHILDHOOD 3.52
2 INTERNATIONAL EDUCATION
UNIVERSITY
3

SECTION G – LANGUAGE PROFICIENCY (Pease tick where applicable)

Speak Read Write
No Type Of Language
Poor Fair Fluent Poor Fair Fluent Poor Fair Fluent
1 MALAY

2 ENGLISH

3 TAMIL

4 ARABIC

SECTION H – WORK RELATED DECLARATION Y Please give details

/
N
Do you have any friends/relatives working in any of the Envo N
1
Bpo Services Sdn Bhd
2 Are you willing to travel/ be relocated? N

Have you been declared BANKRUPT and/or defaulted in any N

3 payment?
(if yes please state when)
Have you ever been convicted of a CRIME? (If yes please state N
4
details)
5 Festive Celebration- Indicate One Y RAYA

6 Do you have any laptop / desktop at your house? Y

7 Please indicate mobile plan you are using? (prepaid / postpaid) Y BOTH

HEALTH RELATED DECLARATION Please give details and date of last occurrence

Have you ever resigned, or been denied a job on health N

8
grounds?
Do you have high blood pressure/Heart N
9
Attacks/Angina/Diabetes/Asthma?
10 Migraine or persistent headaches? N

Eye conditions, restricted vision/glaucoma/iritic/any other N

11
related condition? N
Ear conditions, restricted conditions/tinnitus/ear infection/any
12 other related conditions?

13 Problems related to alcohol or drug abuse/usage or dependency N

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 N
Mental illness and /or stress related problems?
Nervous breakdown / Mental Fatigue /Anxiety / Depression /
14 Panic Attacks / Significant Sleeping Disturbances / Stress
Related Problems / Eating Disorders / Self Harmful / Suicidal /
Any other conditions
N
Have you consulted a specialist or needed any operations other
15
than already stated?
16 Are you receiving medical treatment at the present time? N

Do you take any form of regular medication? For what health N

17
purpose?
Do you any other health issues that have not been mentioned N
18
above or about which you would like to provide further details?
19 Are you pregnant? If yes how many months? N

Do you have any health issue history years back? If yes, please N
20
provide details.

How did you know about this job opportunity?

Tic Source Name and Details
k
Envo Bpo Employee PREVIOUSLY WORKED HERE SO JUST CONTACT
THE PERSON-IN CHARGE
Recruitment Agency
Advertisement – Newspaper / Magazine / Flyer etc
Job / Career Fair
Walk In

DECLARATION

I hereby acknowledge that:-

1. Consent is given to the Company to collect, record, store, use and process “Personal Data”, as defined by the Personal Data
Protection Act 2010 (“PDPA”), concerning and relating to myself, including any sensitive personal data, for the purposes of
processing this employment application for the Company’s consideration, and if successful, would form part of the employment
records with the Company (“Purpose”).
2. Such Personal Data can include, but is not limited to the following:-
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 a. Information provided via forms required by the Company
b. Information from any pre-employment checks, such as medical, bankruptcy, credit and criminal checks deemed necessary
by the Company in relation to the Purpose
c. Information regarding any family members, referees and/or any such other person(s) deemed necessary by the Company in
relation to the Purpose
d. Records of any correspondence and/or communication with representatives of the Company
3. All Personal Data provided is accurate, complete, not misleading and up-to-date and Personal Data of third parties provided is
given with the prior consent from the relevant parties, failing which I indemnify the Company against any claims.
4. Consent is given to the Company to disclose any such Personal Data to any third party including relevant authorities,
subsidiaries, insurers, hospitals, clinics and/or any such person(s) as deemed necessary by the Company in relation to the
Purpose.
5. If your application is unsuccessful, we will keep your information for a reasonable period in accordance with legal requirements
and for administration purposes. We may also contact you if other job opportunities arise in the future which we think may be
suitable for you.
6. If you do not wish for us to contact you for this purpose, please tick this box

I hereby declare that the information given by me in this form is correct and true to the best of my knowledge. I fully understand and accept that if
at any time after employment engagement with the Company, it is found that false declarations have been made in this form; the Company has
absolute right to terminate my employment forthwith.

Signature of applicant: Date: 3RD JANUARY 2023

Name: SALIHA NRIC no: 000603101442

HIRED
REMARKS KIV
REJECT

Interviewed By:

Name : ________________________

Signature : ________________________

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