IDENTITY PERSONNEL ID

Position Proposed : Identity Card No. :

Author :
Full Name : Date of Issue :
Date of Birth : Valid to :
Place of Birth : Place of Issue :
Country of Birth :
Nationality : Driving License No. :
Ethnic Origin : Date of Issue :
Valid to :
Sex Male Female Place of Issue :

Marital Status Single GLASSES ( CYLINDER )

Married Since Right :
Widow / Widower Left :
Divorced Blood Type A B AB O

BANK DETAIL ( filled by : your account in BII or BCA )

Religion Moslem Hindu Name :
Christian Buddhist Account no. :
Catholic Bank Name :
Branch :
ADDRESS
Permanent Address
House Number / Street :

RT RW
City : Zip Code
Kelurahan :
Kecamatan :
Telephone & HP # :
Email :

Temporary Address
House Number / Street :

RT RW
City : Zip Code
Kelurahan :
Kecamatan :
Telephone # :

Emergency Address
Contact Person :
Relation :
House Number / Street :

RT RW
City : Zip Code
Kelurahan :
Kecamatan :
Telephone # :

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FAMILY TREE
Place&Date of Country of
Member Name Sex Age Education Previous employ.
Birth Birth
Father
Mother
Sibling 1
2
3
4
5
6
7
8

Spouse
Children 1
2
3
4
5

EDUCATION
Education
Institute Name & Location From To Certificate Branch of Study
Establishment
Elementary School
Junior School
High school
Academy
Graduate School
Post Graduate School

COURSE - TRAINING
Subject Organizer Place / City Year Sponsored by

LANGUAGE PROFICIENCY ( Filled by : poor, fair, good, excellent )

Language Speaking Writing Listening Remarks

HOBBY READING HABIT

Reading Materials Favorite Topics

SOCIAL ACTIVITY THE AWARD RECEIVED

Organization Position Years ( due to the achievement or participation )

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WORKING EXPERIENCE
From To Name of Company Position Salary Reason for Resign

REFERENCE

Name Address / Phone No. Occupation / Company Relation

DESCRIBE YOUR TASKS & RESPONSIBILITIES IN THE PREVIOUS / CURRENT EMPLOYMENT

DRAW THE CHART OF ORGANIZATION STRUCTURE IN YOUR PREVIOUS / CURRENT COMPANY AND SHOW YOUR POSITION

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 ANSWER
QUESTIONS
Yes No Explanation
Have you ever applied for any position in PT Ecco Indonesia before ?
If yes, when and for what position ?

Besides in this company, where else are you applying currently ?

What position is ?

Do you still bind with a contract of work with your current company ?

Do you have relative(s): friend(s) who is/are working in this company ?

Have you ever suffered from a chronical/serious desease/severe accident/

surgery ?

Have you ever undergone psychotest or psychological examination ?

For what purpose ?

What kind of employment/position do you think match your ambition at

present or in future ?

What kind of work environment do you enjoy most ?

(Factory, Office, Laboratory, Site)

Why are you interested in working with PT Ecco Indonesia ?

What factors do you recognize as your own strong points ?

What factors do you recognize as your own weak points ?

What subjects give you difficulties in decision making ?

What kind of people do you dislike most ?

Who was the best boss you ever had ? Why ?

Who was the worst boss you ever had ? Why ?

In your opinion, which of your qualifications are the most important for this
job ?

What was your best experience in your career ?

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 ANSWER
QUESTIONS
Explanation
What was your worst experience in your career ?

In connection with work, what is the most important to you ?

In connection with your future plan/career, what are your short term plans /
activities that you have been doing ?

How much is your nett income currently ? If you admitted, how much salary do you want to earn ?

What kinds of fasilities do you get from your company right now ? If you admitted, what kinds of fasilities do you expect ?

I shall be fully responsible for any incorrect information above

………………………………..., 20.….

…………………………………………
Applicant/signature

DECISION
( Filled by Personnel Dept. )

The salary of probation period Rp.

The salary after probation period Rp.

Facilities Given :

Employee Status Casual Starting date of Employment

Expatriate < 183 d's
Expatriate > 183 d's
Management Trainee
Probation
Permanent
……………………………………………….
Director/Personnel Manager Signature

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