Sgoi Application Form 2024
Sgoi Application Form 2024
Sgoi Application Form 2024
Pass Fail
Tech/SI
Initials
Ops. Dept. Intro to Principal
___________________
Date Applied: Availability (Month): Email Address:
Present Rank: Higher License/No. Total Years in Rank:
MARINA SID No. E-Registration No. MISMO Acct No. (SRN)
Next of Kin
Name: Date of Birth: Date of Anniversary:
Relationship: (*if married)
Parents Details
Mother’s Maiden Name: Father’s Name:
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SGOI-QMS-5A6-01-02
2 of 4
SGOI-QMS-5A6-01-02
I understand that a strict medical examination including Drug and Alcohol test as per company requirements is a
condition of my employment and I express my willingness to be examined.
I undertake to provide the company’s medical officer full details of my previous medical history.
I agree that the decision of the company medical officer is final.
I declare that there are no criminal/ police investigations in progress against me.
I confirm that all my travel documents are valid and in order. I understand that if my travel Documents become
invalid or restricted at any time during the course of my employment and cannot be revalidated by me under
normal process, the contract of employment will terminate, and all costs of repatriation will be borne by me. I
am /am not presently employed elsewhere.
I also declare that I have no past or present legal impediments that might stop me from working onward
company vessel.
I agree that previous employers may be contacted for information concerning my employment
record and hereby release them from any liability and confidentiality to provide such information.
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SGOI-QMS-5A6-02-02
Name: Rank:
Last Name First Name Middle Name
REMARKS:
DATE: _________________
TO : ___________________________________
ATTENTION : ___________________________________
Dear Sir/Madam
I hereby authorize SYNERGYGROUP OPERATIONS, INC. to conduct a background check from your good
office to ascertain my experience and suitability for employment.
____________________________________
(Rank/Name of Seafarer)
============================================================================================================================================
For SGOI evaluation, may we request for your comment/s based on the criteria below and kindly return it to us
through electronic means.
Any and all information given will be treated strictly confidential.
ASSESSMENT
Synergygroup Operations Inc. (SGOI) aims to comply with the Data Privacy Act of 2012 (DPA) and cooperate fully with the National
Privacy Commission (NPC). This Privacy Statement describes how SGOI collects, uses, and discloses certain personal information
obtained through your engagement of our services for:
- Job Application
- Documents Submission as required for Recruitment and Selection Process
- Job Offer
- PEME as required by DOLE
- Training requirements
- Insurance coverages / Compensation and Benefits Process
- Tax information
- Payroll management and social benefits and performance monitoring and
This Privacy Statement does not address information collected through other sources such as personal contacts.
C. Data Protection
We shall implement reasonable and appropriate organizational, physical, and technical security measures for the protection of personal
data which we collected. The security measures shall aim to maintain the availability, integrity, and confidentiality of personal data and
are intended for the protection of personal data against any accidental or unlawful destruction, alteration, and disclosure, as well as
against any other unlawful processing. We only permit your data to be accessed or processed by our authorized personnel who hold such
information under strict confidentiality. We restrict access to information to just anyone who like to know/obtain such information
without justifiable ground.
Any data security incident or breach that comes to the knowledge of the SGOI will be recorded and reported as required by law. SGOI
will take all necessary and reasonable steps to address such incident or breach and mitigate any negative effect of such incidentor breach.
If there is strong suspicion that an incident affects your personal information, SGOI will notify you of such incident in an appropriate
manner.
E. Retention Period
We retain your Personal Information for as long as reasonably necessary for and/or relevant to business activities related to the
Purpose. Kindly note that it will be necessary for SGOI to process your Personal Information for the Purpose, without which we will not
be able to carry out the Purpose.
F. Confidentiality
Our employees shall operate and hold personal data under strict confidentiality. They are required to sign non-disclosure agreements
and have received training on the company’s privacy and security policies to ensure confidentiality and security of personal data.
G. Right to Privacy
As provided by the DPA, you may object to the processing of your personal data, request to access your personal information, and/or have
it corrected, erased, or blocked on reasonable grounds. For the details of your rights as a data subject, you can get in touch with our Data
Privacy Officer or at National Privacy Commission at https://privacy.gov.ph/. SGOI will consider your request and reserves the right to
deal with the matter in accordance with the law.
H. Privacy Violations
If you reasonably believe that we have committed any violation of your rights as a data subject and/or of applicable data privacylaws,
you may contact us by sending an email to dpo@synergygroup.ph.
SGOI-QMS-5B6-01-01
I. Contact Information
If you have further questions or concerns regarding your privacy rights, this Consent Form or any matter regarding the Data PrivacyAct of
2012, you may contact our Data Protection Officer through the following details:
CONSENT
I acknowledge and agree that SGOI may share these data between them and such data may constitute my personal or sensitive
personal information (which includes without limitation, my name, address, gender, age, marital status, contact details, birthday,
SSS, TIN, education, employment information, financial information, medical information, spouse details, preferences, behavior,
and other information classified as "personal data," "personal information," or "sensitive personal information" under the Data
Privacy Act), as well as information relating to my accounts, transactions and communications with my principal employer or to
any person, entity or body in relation to my work. Said data may be collected, processed, stored, updated, or disclosed by SGOI in
accordance with its Data Privacy Notice. My information may continue to be collected, stored, processed and/or shared between
and among thepersons, entity or body until deemed necessary.
I also acknowledge and warrant that I have acquired the consent from all parties relevant to this consent and hold free and
harmless and indemnify SGOI, its directors, officers, employees and its principals from any complaint, suit, or damages which any
party may file or claim in relation to my consent.
I also acknowledge and consent that SGOI will also record my personal information for purposes of record-keeping. Further, I
understand that I may access, update, or correct certain personal information, or withdraw consent to the use of any of my
information as set out in this letter at any given time by communicating with SGOI’s Data Protection Officer.
I hereby acknowledge that I have been provided with the written notification on my/our rights as a Data Subject (each, a "Right",
collectively, the "Rights").
I have read this form, understood its contents and consent to the processing of my personal data. I understand that my consent
does not preclude the existence of other criteria for lawful processing of personal data and does not waive any of my rights under
the Data Privacy Act of 2012 and other applicable laws.
_______________________________________
Signature above printed name
Date: ______________________________