Employment Application Form

Field of Study: Power Plant Engineering

Name : ANNISA BUDIARTY

First Name Middle Name Family Name
Mailing Address: annisabudiarty@gmail.com Telephone No.: +6282128102967

1. Age 19 2. Birth Date April 18th, 1998 3. Place of Birth Jakarta

4. Citizenship Indonesian

5. Religion Islam
6. Home Address Cidamar street, Bandung city, West Java

7. Marital Status: 􀙪Single 􀙪Married 􀙪Separated 􀙪Widow

8. Name of Spouse: ______________________________________________________________________

9. Spouse’s Occupation/Employer: ________________________________________________________

10. Number of Children _________________________ 11. Their Ages ___________________________

12. Father’s Name Occupation Highest educational Attainment

BEMI BUNYAMIN ________________________ Bachelor______

13. Mother’s Name Occupation Highest educational Attainment

UCU ROHAETI ________________________ Senior High School

14. Are your parent living? Father No Mother Yes

15. Please list all secondary schools, colleges, and universities attended.

Secondary Schools, Location Dates Attended Educational

Colleges and Graduate from …… to …… Degree Received

Schools Attended
(State In Full)

SMPN 1 BANDUNG Bandung 2010-2013 ________________

SMAN 6 BANDUNG Bandung 2013-2016 ________________
Politeknik Negeri Bandung West Bandung 2016-2020 Bachelor of sains
16. State major and minor fields of study and discuss your basis of selection.

Power plant engineering studying about power plant design, how it works and the
principle of energy engineering. Major of this study are thermodynamic, heat transfer, mass

balance, electronic, all of study that discuss about energy conversion. The minor one such as
piping, welding, and other subject that support it.

17. Distinctions, Honors, Awards (academic, extracurricular, business, community, or others)

18. College Extracurricular/Business or Community Activities or Involvement

Activities Number of Years of Position held, if any

Membership/Involvement

Eltras Radio Activity Unit 2 years Member of marketing and public relation

Himpunan Mahasiswa Teknik Energi 4 Years Member of informations and communications

FKMTEI 3 Year Member of “Komisi 2”

19. Briefly describe your involvement in the activities listed in No. 18 and their importance to
you.

In eltras radio unit, I become a member of marketing and public relations in that
organization on 2017-2018 period. In that organization I learn about public relation,

announcer, marketing, and many more. I handle the social media of eltras radio
In HMTE, my department developed the editing skills.

20. Did you have part-time work while in college? If yes, describe it briefly.
No.

21. Describe your avocations and hobbies.

I like reading a fiction book, listening the music, and watching the film. I usually

watching the film to relax my mind.

22. Full-Time Position Held. List each position separately with most recent job first.
a. Employer
 _____________________________________________________________________________________
Nature of Business
_____________________________________________________________________________________
Employer’s Address
_____________________________________________________________________________________
Date Employed
_____________________________________________________________________________________
Responsibilities
_____________________________________________________________________________________
Reason for leaving
_____________________________________________________________________________________

b. write the same as above (if you had huge working experiences)

23. Training Programs/ Seminars/Conferences Attended

a. Training/Seminar : FFO seminar
________________________________________________________________________
Conducted by : HMTE
________________________________________________________________________
Inclusive dates : April, 2017
________________________________________________________________________

b. Training/Seminar : Butterfly seminar

________________________________________________________________________
Conducted by : Bandung State Politechnic
________________________________________________________________________
Inclusive dates : August, 2016
________________________________________________________________________

c. write the same as above (if you attended more seminars/trainings)

24. Please make a candid self-assessment of what you consider to be your strengths and

areas of improvement.
I have good in communication and teamwork skills. And a highly sales production in

electricity or energy consumptions. My weakness is sometimes I forget about the

homework when I busy in my organization. So, I must to prepare my schedule and write
my schedule very well.
25. Briefly describe what you believe to be your three most substantial accomplishments and

explain why you view them as such.

Three most accomplishments in my life are my mother and my friends. My best inspiration

my mother. Because my mother is a strong person, hardwork, and never to give up. And
I want to be like her.

26. Please describe a situation in which you felt you had some responsibilities. This situation
is perhaps taken from family, school, business, community or military life. Describe how

this situation developed, your involvement or participation in it, the outcome, and what
you learned from this experience.

27. What are your future plans (family, career, etc.)? Describe it.

When I graduated from my college, I will get some job in geothermal companies. I will
begin my career from beginning. Work hard to upgrade my position in company, make my

family happy and proud of me,