CANDIDATE INFORMATION

Full Name
Sex
Place, Date of
Birth
Religion
Nationality
Ethnic
Marital Status

(Sum of children :

Current Mailing Address:

Own house
Others

Rented house

Parents

Own house

Rented house

Parents

Others

Tel. No. (Off)

(Res)
Facs.

E-mail:
Driver License:
Yes / No

Permanent Mailing Address:

Tel. No. (Off)

(Res)
(H/P)

PHOTO HERE

(H/P)

Facs.

E-mail:
Do you own a car:
Yes / No

ACADEMIC INFORMATION
ACADEMIC INFORMATION
From To

Schools, Colleges, Universities

Major

GPA

Diploma
(Yes/No)

SEMINAR/COURSE/WORKSHOP
SEMINAR/COURSE/WORKSHOP

From To

Topic

Organizer & Location

(States dates)

Start Date End Date

Certificate
(Yes/No)

Company

WORKING EXPERIENCE
WORKING EXPERIENCE

Job Category

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS
Position :
Date of employment :

until

Company
Company Address
Business Line
Current Position
Report directly
(Name/Position)
Total number of employees
Number of Sub-Ordinates
Job Description

Achievement

How did you get employed

Reason for leaving
Last Drawn Salary

(Through Advertisement, Recommendation, etc.)

ORGANIZATION STRUCTURE
ORGANIZATION STRUCTURE

Sruktur organisasi perusahaan terakhir

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS
Position :
Date of employment :
Company
Company Address
Business Line

until

Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description

Achievement

How did you get

employed
Reason for leaving
Last Drawn Salary

(Through Advertisement, Recommendation, etc.)

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS
Position :
Date of employment :

until

Company
Company Address
Business Line
Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description

Achievement


How did you get
employed
Reason for leaving
Last Drawn Salary

(Through Advertisement, Recommendation, etc.)

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS
Position :
Date of employment :

until

Company
Company Address
Business Line
Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description

Achievement

How did you get

employed
Reason for leaving
Last Drawn Salary

(Through Advertisement, Recommendation, etc.)

EMPLOYMENT DETAILS
EMPLOYMENT DETAILS
Position :
Date of employment :
Company

until

Company Address
Business Line
Current Position
Report directly
(Name/Position)
Total number of
employees
Number of Sub-Ordinates
Job Description

Achievement

How did you get

employed
Reason for leaving
Last Drawn Salary

(Through Advertisement, Recommendation, etc.)

ADDITIONAL INFORMATION
ADDITIONAL INFORMATION
SPECIAL ACTIVITIES
From To

Name of Organization

Place

Position

LANGUAGE SKILLS
Language

Notes:

Reading

E = Excellent,

Writing

G = Good,

OTHER PERSONAL INFORMATION

Speaking

F = Fair,

Understanding

P = Poor

Computer Proficiency

(Program/Language

Other Skills &

expertise
Interest
What do you do in your leisure time?
What are your hobbies?
Do you read:
a lot
What kind of topics do you read?

few

a little

You subscribe to (newspaper, magazines, etc.):

Core competencies:
Have you been dismissed or suspended from any position?
If so, state details
Are you engaged in any business?
Yes
What kind of business?
Current Salary:
Details of current remuneration package:
Do you have any other sources of income?
When are you available for work:

Yes

No.
No.

Expected salary:

Yes

No.
Notice Period:

FAMILY DETAILS
FAMILY DETAILS
Relationship

Name

Age

Last Education

Occupation

Father
Mother
Husband/Wife
Child
Brothers/Sister

You have ____________brother(s)/sister(s) and are the _______________child in the family.

EMPLOYMENT REFERENCES
EMPLOYMENT REFERENCES

Name:

Name:

Position:
Company Name:
Company Address:

Position:
Company Name:
Company Address:

Nature of Relationship:
Tel: (Office)

(Res)

Nature of Relationship:
Tel: (Office)

(Res)

By signing this form I certify that the information in this application is factually correct, honestly presented, and is
an accurate account of my professional experience. Should it be untrue, I would be prepared for a dismissal at any
time without any conditions.

Signature: __________________________

Date: _____________________________