Page 1 of 11

CyberSecurity Malaysia Collaboration Program (CCP) Application Form.

1. NOTES FOR FILLING THIS APPLICATION FORM
Please complete all portions of this application form and provide all the supplementary information wherever applicable. The answers must be concise and clear to ensure fast and efficient processing of the application form.
Please upload, where appropriate, supporting documents to provide clarity and credibility to the information provided. Ensure that all uploads are clearly marked with the name of your company and the number of the question to which they refer.
Important Note: This is a confidential document and the information entered and submitted as part of this document will be handled with confidentiality.
2. FINANCIAL INFORMATION
2.1 General Company Details
Invalid input
Invalid Input
Ownership Structure
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid input
Invalid input
2.2 Authorised Signatories
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Please type your full name.
Please type your full name.
2.3 Financial Capacity
Please enclose the following documentation or provide information for the following key financial parameters –
Invalid Input
Invalid Input
3- Local Company information
Invalid Input
Invalid Input
4- Foreign Company information
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
3. PEOPLE, PRODUCTS, PROCESSES and TECHNOLOGY (PPPT)
Invalid Input
3.2 Key Management and Professional Staff
Please list the Management Staff and the key Professional Staff in your company (provide as much information as possible) – i. Staff Name; ii) Designation; iii) Qualifications; iv) No. of years in Industry.
Invalid Input
3.3 Staff Data
Please provide the following information pertaining to your company’s staff –
Invalid Input
Invalid Input
Invalid Input
Invalid Input
Invalid Input
3.4 Products and Services
Please list the key products and services provided by your company in this relevant domain and among them highlight the following information –
Invalid Input
Invalid Input
Invalid Input
Invalid Input
4. BUSINESS EXPERIENCE
4.1 Past Experience
Please list key projects worked on in the cyber security domain over the past three (3) years in collaboration with government agencies or other clients (provide as much information as possible) – i. Client name; ii. Project name and scope of the project; iii. Duration and Value of the project; iv. Key locations covered as part of the project.
Invalid Input
4.2 Customer References
Invalid Input
Please provide references of customers with whom you worked over the past three (3) years – i. Customer name; ii. Contact person; iii. Contact number; iv. Email Address.
Invalid Input
SIGN-OFF SHEET
I hereby acknowledge on behalf of the company that the attached documents and information provided in the application form is true to the best of my knowledge. I authorize the use to this information for CyberSecurity Malaysia Collaboration Program (CCP) processing.
Please type your full name.
Please type your full name.
Invalid Input
Invalid Input
Invalid Input