Alorica Forms
Alorica Forms
Alorica Forms
Date of Birth:*
SSS No.:(*required) TIN:(*required)
MM:* DD:* YY:*
Place of Birth:*
Philhealth:(*required) HDMF:(*required)
Citizenship:* Civil Status:* □ Single □ Married □ Widow/Widower
□ Legally Separated
Contact no./nos.:* Email Address:*
Complete Mother's Maiden Name:* Complete Father's Name:*
In Case of Emergency Contact Name: *___________________________________ Contact No.:*_______________________ Relationship:*______________________
Complete Permanent Address: *
Name of School attended Course Taken School Year Location Highest Attainment
High School *
□ Graduate
□ Senior □ Junior
□ Graduate
College* □ Under Graduate
□ Vocational
Work Experience/s (List all employment for the past 7 years including military service and self-employment)
Company Name Business Address Job Title Start Date End Date Supervisor Name Contact No.
Character Reference/s (Minimum of 3 persons but not including any immediate family members)
Name: Contact Number Company Name Designation Relationship
*
*
*
Self Declaration/Authorization
Dear Sir/ Madam:
I am currently seeking employment with Alorica. As part of Alorica’s procedure of processing my application, an investigative report about my background may be made. I,
therefore, authorize Alorica to investigate information concerning my education, employment and all other aspects of my background relevant to my proposed employment. I also
certify that all information supplied in conjunction with my application are true and correct in all aspects and I have not willfully suppressed any fact. Your assistance in providing
Alorica the information requested will be highly appreciated as it would help facilitate the processing of my application.
I further acknowledged that all personal information provided herein will be used for purposes of my proposed employment application. Thus, I hereby authorize the processing of
my personal information including but not limited to the collection, recording, organization, storage, updating or modification, retrieval, consultation, disclose, and use of
information contained herein, including supporting documents, necessary for the administration of this application.
I am currently employed with, or have expressed interest in an employment position in the Alorica group of companies which
includes Alorica Philippines, Inc., Alorica Asia (ROHQ), Ltd., Alorica Teleservices, Inc., and Alorica Clark Philippines, Inc.
(“collectively referred to as “Alorica”) that is subject to the requirements of the Data Privacy Act of 2012, its Implementing Rules
and Regulations, and other issuances of the National Privacy Commission (collectively, “Data Privacy Act”) and relevant laws and
regulations pertaining to the processing of personal information.
I acknowledge that Alorica holds personal information, including sensitive personal information (as such terms are defined by the Data
Privacy Act), relating to its prospective, current, and former employees (collectively, “Employee Data”) in its capacity as employer
and in the conduct of its business.
Personal information includes my name, address, contact details, birthdate, and any other information which may reasonably identify
me. Sensitive personal information includes my race, ethnic origin, gender, age, marital status, health information, education,
employment information, financial information, genetic information, government issued numbers, tax returns, and other information
classified as “sensitive personal information” under the Data Privacy Act.
I agree that Alorica may process my Employee Data for the following legitimate purposes:
I agree that my Employee Data may be disclosed to the following recipients or classes of recipients:
Alorica may also disclose Employee Data about its employees because of a sale of the assets of Alorica, mergers, acquisitions, or in
preparation for any of these events or events similar thereto, and pursuant to laws, regulations, and court orders or subpoenas that may
be received by Alorica.
I agree that my Personal Data may be disclosed and retained in or outside the country or jurisdiction in which information is originally
collected and retained.
I acknowledge that I have the right to access, update, and correct my Employee Data in my personnel records. I understand that I may
also opt-out from any processing activity unless the processing is allowed by contract, is necessary to comply with a legal obligation, is
necessary to protect vitally important interests an employee, is due to legitimate interests, is required by existing laws and regulations,
is necessary to protect the life, safety, health and well-being of the employee, is necessary to provide medical treatment, charitable
support is required in court proceedings, or legally mandated by government authorities.
I hereby acknowledge that I have been informed by Alorica of its use of my Employee Data in accordance with relevant laws. I hereby
expressly authorize Alorica to collect, process, and transfer my Employee Data that Alorica deems necessary to effectively and
efficiently administer the employment and conduct its business, for as long as necessary to fulfill the purposes of processing mentioned
above.
Date
For your data privacy concerns and requests, you can email the following Data Protection Officers:
a. Ms. Karen Marie Tomas ([email protected])
b. Ms. Bituin Bautista ([email protected])
2
Date__________________
Consent
Pursuant to such efforts, I was informed that the Alorica Group, in collaboration with CCAP, will participate in the
implementation of a Critical Incident Report (“CIR”) Project, a centralized database containing specific personal information ,
sensitive or otherwise, of current and former employees, of CCAP-member companies, including information on any fraud-related
internal disciplinary proceedings conducted against me and any civil and/or criminal cases arising therefrom.
As a data subject whose personal information, sensitive or otherwise, will be processed in relation to the CIR Project, I acknowledge
having viewed and provided with access to a copy of the Alorica Group’s Privacy Notice made in compliance to Republic Act no. 10173,
otherwise known as the Data Privacy Act. Having fully read and understood said Notice, I recognize the following:
1. I have been duly informed of the nature of the personal information to be processed in the CIR Project;
2. I have been informed of the scope, source and method of the personal processing involved in said project;
3. I have been informed of the purpose of such processing as well as the legitimate interests of the parties involved thereto;
4. I have been informed of the intended recipients of my personal information, sensitive or otherwise;
5. I have been informed of how long my personal information, sensitive or otherwise, will be retained; and
6. I have been informed of my rights and obligations as a data subject under the Data Privacy Act and its implementing rules and
regulations.
In support of the CIR Project, I expressly agree to the processing and disclosure of my personal information, sensitive or otherwise,
in accordance with the policies set forth in the Privacy Notice. In so giving this authority, I hereby warrant that my consent is freely given and
is an informed indication of my will.