Position Applied for : Zara Customer Service Executive
Date & Time: 20-05-2020
Please tick & state how you know about this job opportunity.
Job Portals : Jobstreet Social Media: Career Fair:
Internal Referral, Staff Name: Walk in: Others:
APPLICATION FORM
SECTION A – PERSONAL PARTICULARS
Name (As per
VAISNAVI NAIDU A/P MUNIANDY
NRIC/Passport)
Old NRIC/Passport
NRIC/Passport no. 000409-14-1096
no. -
Date of Birth
Age (years) 20
(dd/mm/yy) 09-04-2000
SENTOSA MEDCAL CENTRE
Place of Birth Nationality
KUALA LUMPUR MALAYSIAN
Gender FEMALE Race
INDIAN
Religion HINDU Marital Status
SINGLE
Current resident address: NO.14, JALAN MUTIARA 2C, TAMAN SELAYANG MUTIARA, BATU CAVES, 68100,
SELANGOR, MALAYSIA
Postcode: 68100 Province: SELANGOR Country: MALAYSIA
Permanent address (Expatriate to provide home country address): NO.14, JALAN MUTIARA 2C, TAMAN
SELAYANG MUTIARA, BATU CAVES, 68100, SELANGOR, MALAYSIA
Postcode: 68100 Province: SELANGOR Country: MALAYSIA
Email vaisnavinaaidu@gmail.co
Contact number +60167824022
Address m
Mode of travelling ☑ Train (LRT, MRT) □ Bus ☑ Car □ Motorcycle
SECTION B – FAMILY PARTICULARS
Spouse Name (As per
- NRIC/Passport no. -
NRIC/Passport)
Yes
Is your Spouse working?
No ( if yes please provide information below)
Company Name - Company Contact no. -
Position held -
Different Please explain
Gender Date of Birth Cert/
Children Age abilities the different
(M/F) birth NRIC No.
(Y/N) abilities
-
If any of your children have different abilities, are they registered by Social Welfare Department
Y/N
(JKM)?
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SECTION C – CURRENT/PREVIOUS EMPLOYMENT DETAILS
Month/Year
Other variables
Company Position Held Reason for leaving Basic Salary
(Allowance, benefits etc)
From To
SCICOM (MSC) BHD CUSTOMER JANUA 8TH MAY WORKING HOURS RM2500
SERVICE RY 2020 EXCEEDED 13
EXECUTIVE 2020 HOURS PER DAY
WITHOUT OVER
TIME PAYMENT
GIVEN
BENDIGO MARKETING TELEMARKET JANUA MARCH TO CONTINUE RM1700
ING RY 2018 EDUCATION
SDN BHD CONSULTAN 2018
T
S.M. ANDY BANNER JULY JANUARY WAS WORKING FOR RM 0
DESIGNER 2015 2018 FREE AND GOT A
ENTERPRISES NEW JOB
BITZ AGENCY PROMOTER DECEM APRIL 2018 WORKED 2 RM800
BER (1 MONTH) MONTHS
2017 (1 ( DEC&APRIL)
MONT ,NUMBER OF
H) WORKING DAYS
WERE LOW
(WEEKENDS ONLY)
SECTION D – REFERENCES (Please provide two referees from your previous employment and they must be your
superior / supervisory level)
Years known each
No Name Company Name Relationship Contact Numbers
other
1 ZAKWAN SCICOM (MSC) BHD TEAM LEADER +60 14-300 8407 4 MONTHS
BENDIGO
2 DISHA SUPERVISOR +60 12-458 6632 3 MONTHS
MARKETING SDN BHD
SECTION E – EDUCATION BACKGROUND (From highest to lowest)
Year
No Name of University/College/School Qualification Field of Study Grade/CGPA
From To
STPM
1 DESA MAHKOTA FORM SIX COLLEGE STPM 2018 2019 2.42
[ SCIENCE(PHYSICS) ]
2 As,4 A-s,2
2 SAINT MARY’S SECONDARY SCHOOL SPM 2013 2017 SPM [SCIENCE]
B+s and 1C+
SECTION F – LANGUAGE PROFIENCY (Please tick where applicable)
Language Language 1: ENGLISH Language 2: MALAY Language 3: TELUGU Language 4:HINDI
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Poor Fair Fluent Poor Fair Fluent Poor Fair Fluent Poor Fair Fluent
Speak / / / /
Read / / / /
Write / / / /
SECTION G – WORK RELATED DECLARATION Yes/No Remarks
Do you have any friends/relatives working in Aegis BPO
1 Malaysia Sdn Bhd? If yes, please provide details (Name NO
& Department
Have you worked in Aegis Global? If yes, please provide
2 NO
details
Have you been terminated from employment before? If
3 NO
yes, provide details
Do you hold a directorship in any company? Does your My father owns a used car business and I have been
4 family has own business? Are you involve? If yes, please YES helping him in his company’s banner designing since I
provide details was 15 years old
Are you doing part time job after working hours or on
5 NO
weekends? If yes, please provide details
a) Have you been declared BANKRUPTCY and/or
NO
defaulted in any payment? If yes, please provide details
b) Have you ever convicted for any CRIMINAL
6 NO
OFFENSES? If yes, please provide details
c) Do you have any FINANCIAL ISSUES with any
financial institution? (PTPTN, MBSB etc…) If yes, NO
please provide details
SECTION H – HEATH RELATED DECLARATION Yes/No Please give details
Do you have any health related issues? (Alcohol, drugs
1 YES ASTHMA
etc) If yes, please provide details
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Do you have Mental illness and/or stress related
2 problems? (Anxiety, Depression etc) If yes, please NO
provide details
Have you consulted a specialist or needed any operations
3 NO
other than already stated? If yes, please provide details
4
Are you receiving medical treatment at the present time?
YES
I had gotten stitches near my forehead due to an
If yes, please provide details injury caused by falling in the bathroom
6 Are you pregnant? If yes, please provide details NO
7
Have you take sick leave within the last 1 year of your
YES
Had severe eye pain and migraine due to excessive
employment? If yes, please provide details working hours (13 hours +)
Have you been hospitalized within the last 2 years? If yes,
8 NO
please provide details
Do you have any follow up medical checkup? If yes,
9 NO
please provide details
SECTION I – BACKGROUND SCREENING
Yes/No Please give details
QUESTIONS
Have you applied for any other jobs? If yes, please
1
provide details
YES I was looking for a job but now, not anymore
Have you attended any interviews in the last 1
2 NO
month? If yes, please provide details
Do you have any of your family members admitted
3 in hospital or they are very ill? If yes, please NO
provide details
Are you planning to further your studies/ get
I am planning to continue my studies and my
4 married near future (within 1 year)? If yes, please YES
provide details degree intake is in September 2020
Do you have any pre planned leave? If yes, please 17TH June 2020 and 20th July 2020 - Have to
5 YES
provide details attend prayers if weekends excluded
SECTION J – JOB EXPECTATIONS
Over time payment is
Expected Basic Salary RM2500 Allowance/Other Benefits
given
Preferred Job Type(s) Customer Service Able to travel/relocate Yes
1 month prior Earliest availability to join
Notice to current employer (duration) 21-05-2020
notice Aegis (dd/mm/yy)
Able to work on weekends & Public Holidays-YES
Ability to work on Rotation Shift Yes / No
public holidays Weekends-NO
DECLARATION
I hereby acknowledge that:-
1. Consent is given to the Company or its duly appointed agent 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 may 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
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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 the Company’s duly appointed agent, relevant authorities, subsidiaries, insurers,
hospitals, clinics and/or any such person(s) as deemed necessary by the Company in relation to the Purpose.
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. I agree to
inform Human Resource Department (HR) if there is any change to the current information provided by me in this form.
Signature of applicant:
NRIC number:
000409-14-1096
Name of applicant: 20-05-2020
VAISNAVI NAIDU A/P MUNIANDY Date:
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