PERKESO

E1. Year and month of working experience*

Year(s)

Month(s)

E2. Highest level of education*

E3. Do you have any disabilities?*

Yes

No

If you answered 'yes' to the above question, please specify your disabilities*

E4. Have you received any benefits from SOCSO?*

Yes

No

E5. Have you applied for PERKESO's Invalidity Pension?*

Yes

No

If yes, please enter the Invalidity Pension Number.*

E6. Have you previously applied for disability benefits at SOCSO?*

Yes

No

E7. I agree to begin participating in the Re-Employment Placement Program and follow the instructions as prescribed by SOCSO*

Yes

No

E8. I hereby authorize SOCSO to give my information to employers for the Re-Employment Placement Program and Labour Market Information*

Yes

No

EMPLOYMENT INSURANCE SYSTEM BENEFITS PORTAL