Please APPLICATION FOR EMPLOYMENT

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The position being applied for

Location :

I - PERSONAL PARTICULARS
1 Name : Surname :

2 Date & Place of Birth :

3 Registered Address (KTP):

: Postal Code :

Mailing Address :

: Postal Code :

4 Telephone No : (Mobile) (Home)

5 Nationality :

6 Sex : Male/Female

7 Marital Status : Married/Single/Widow/Widower Date of marriage :

Name of spouse : Date of birth :

Occupation :

Name of children (if any) Date of birth

Mother's maiden name :

8 Health condition : Height : cm

Weight : kg

9 Emergency Contact Information

Name : Relationship :

Telephone No : (Mobile) (Home)

II - EDUCATIONAL BACKGROUND
A Formal Education
1. Tertiary education

Name of Univ. Degree obtained From (Year) To (Year) GPA

What is your major studies/specialization (s) ?

2. Secondary education
Name of High School From (Year) To (Year) Passed/Not
 B Further relevan education/special training courses, etc. attended after leaving school/university

Name of Courses/ Names & Places of Institutions Date/Year

Training Program Conducting the Courses attending
1)

2)

3)

C Language proficiancy Verbal Written

III - EMPLOYMENT HISTORY

Permanent Jobs (Start with your current job if you are now employed)

1 Name and address of employer/company

Phone :
Position : From - to :
The title (position) of your immediate Superior
Last salary : Rp.
and benefits
Main responsibilities :

Reason for leaving :

2 Name and address of employer/company

Phone : From - to :
Position :
The title (position) of your immediate Superior
Last salary : Rp.
and benefits
Main responsibilities :

Reason for leaving :

 3 Name and address of employer/company

Phone :
Position : From - to :
The title (position) of your immediate Superio
Last salary : Rp.
and benefits
Main responsibilities :

Reason for leaving :

4 Name and address of employer/company

Phone : From - to :
Position :
The title (position) of your immediate Superio
Last salary : Rp.
and benefits
Main responsibilities :

Reason for leaving :

IV - GIVE A BRIEF DESCRIPTION OF YOUR ACHIEVEMENT SO FAR

V - ACTIVITIES OUTSIDE THE JOB

A State your extracurricular, interests, hobbies, etc. :

1)
2)
B Organizations (Social, Politic, Proffesional, etc.)

Name of organization Position Held

1)
2)
VI - STATE YOUR EXPECTATIONS FROM THIS COMPANY

VII - REFERENCES
Please provide references : relatives (family members) should not be given as references
Name Occupation/Position Address Tel. No.
1)

2)
3)
4)

When can you start working

Signature of Applicant : Date :

as references