ENVO BPO SERVICES SDN BHD

APPLICATION FORM
APPLICATION FOR EMPLOYMENT
Position Applied For : Executive Customer service Department:
TUMi

SECTION A – PERSONAL PARTICULARS

Name (as per IC): Harith Fadli Bin Hashim Other Name:

IC No. (New): 920814115627 Date of Birth: 14/08/1992

Place of Birth: Kuala Terengganu Nationality: Malaysian

Age: 31 Gender:

Permanent Address: Correspondence Address (if different from previous):

28 Jalan Melor, Kg Raja Uda, 42000 , Pelabuhan Klang, Selangor.

Tel. No: H/Phone No: 01160632396

Race: Malay Religion: Islam

Marital Status: Single

Email Address: cracklarkin77@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

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Child certified by the Department of Social Welfare to be disabled

EMERGENCY CONTACT (To be contacted in case of emergency)

No Name & Address Relationship Contact No.
1 Amir Faiz Bin Hashim Sibling 01734596789
2 Hazirah Farhanah binti Hashim Sibling 0172936580

SECTION C – SALARY CREDITING AND STATUTORY CONTRIBUTION / DEDUCTION

EPF NO : Income Tax No:

SOCSO NO : Bank Name: CIMB

(NOTE: Public Bank)

BANK ACCOUNT NO: 7056645400

SECTION D – EMPLOYMENT HISTORY (Start with most current)

Employer’s Name & Year Last Drawn
No Position Held Reason For Leaving
Address From To Salary
1 Mas Cafe Customer Service 2010 2012 Cloaed Rm 2000
2 Part time Part time 2015 Present
3

Current Expected
Basic Salary
Rm 2300
Allowance/Other Benefits
Notice Period: Possess Own Transport: Yes / No Preferred Job Type(s):
Immediate □ Full-Time
Earliest Availability: Preferred Work Location: Selangor □ Contract: …………….(Duration)
Are you willing to
work on shift : Yes / No

SECTION E – REFERENCES (Please provide one personal and one previous employer)
No of
No Name Address Contact No. Years
Known
1

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

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4

SECTION F – EDUCATION BACKGROUND (From highest to lowest)

Name of University / Year Grade /
No. Qualification Obtained Field of Study
College/School From To CGPA

1 Foundation in Management 2.54

Universiti Selangor Passed 2013 2015
2 Sekolah Menengah Teknik Klang
Passed 2008 2009 SPM
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

SECTION H – WORK RELATED DECLARATION Y Please give details

/
N
Do you have any friends/relatives working in any of the
1
Envo Bpo Services Sdn Bhd N
2 Are you willing to travel/ be relocated? Y
Have you been declared BANKRUPT and/or defaulted in
3 any payment?
(if yes please state when) N
Have you ever been convicted of a CRIME? (If yes
4 N
please state details)
5 Festive Celebration- Indicate One Hari raya aidilfitri/aidiladha
6 Do you have any laptop / desktop at your house? Y
Please indicate mobile plan you are using? (prepaid /
7 Prepaid
postpaid)
Please give details and date of last
HEALTH RELATED DECLARATION
occurrence
Have you ever resigned, or been denied a job on health
8
grounds? N
Do you have high blood pressure/Heart
9
Attacks/Angina/Diabetes/Asthma? N
10 Migraine or persistent headaches? N
Eye conditions, restricted vision/glaucoma/iritic/any other
11
related condition? N
12 Ear conditions, restricted conditions/tinnitus/ear N
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 infection/any other related conditions?

Problems related to alcohol or drug abuse/usage or

13
dependency N
Mental illness and /or stress related problems?
Nervous breakdown / Mental Fatigue /Anxiety /
14 Depression / Panic Attacks / Significant Sleeping N
Disturbances / Stress Related Problems / Eating
Disorders / Self Harmful / Suicidal / Any other conditions

Have you consulted a specialist or needed any

15
operations other than already stated? N
16 Are you receiving medical treatment at the present time?
N
Do you take any form of regular medication? For what
17
health purpose? N
Do you any other health issues that have not been
18 mentioned above or about which you would like to
provide further details? N
19 Are you pregnant? If yes how many months? N
Do you have any health issue history years back? If yes,
20
please provide details. N

How did you know about this job opportunity?

Tic Source Name and Details
k
Envo Bpo Employee
Recruitment Agency
Advertisement – Newspaper / Magazine / Flyer etc
Job / Career Fair
Walk In

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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:-
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:____________________ 06/04/2023

Date:________________________

Harith Fadli Bin Hashim

Name:____________________________________ 920814115627
NRIC no.:_____________________

HIRED
REMARKS KIV
REJECT

Interviewed By:

Name : ________________________

Signature : ________________________
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