ASTRA, a world of opportunities

APPLICATION FORM
Astra 1st Program

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PERSONAL IDENTITY
Full Name: Salim Muhammad
Place & Date of Birth: Padang, 24 August 1995
Address: Hankam Raya St. Jatiwarna Indah Residence, D/22, RT 07, RW 11,

Email: salim.muhammad@rocketmail.com
Phone Number: 021-8485689
Mobile: 083821845009
EDUCATION BACKGROUND
High School : MAN 2 Jakarta (Islamic High School 2 of Jakarta)
University: Padjajaran University
GPA: 3,10
Faculty: Science

Semester: 2

Major: Physics Concentration of Geophysic

Credits have been taken: 41

Title of your final project: (if any)

Expected time of graduation (month and year):

SPECIAL COURSE / TRAINING ATTENDED:

Year

2008

Course / Training

English Training and Brain

Capacity Treatment

Place / Insitution

Remark

IKO TREATMENT (www.ikotreatment.com)

ASTRA, a world of opportunities

EXTRA CURRICULAR ACTIVITIES
(specify organizational activities you have attended within a maximum of 2 years and showed
the greatest contribution that you provide)
Activities /
Organization

Year

Organization
Scope

Position
Held

Responsibilities

WORK EXPERIENCE (Including part time job, freelance, internship, etc.)

Year

Company

Position Held

Responsiblities

SPECIAL AWARD
Please mention award(s) you have been received and explain it briefly (academic honors,
distinction, scholarship, etc)
Year

2010

Award

Institution

Remarks

1st in East Jakarta Mathematic UIN JAKARTA

Olympiad

ASTRA, a world of opportunities

INTEREST
What do you usually do in your spare time?
Studying, if Im boring, I tried to write a story for my novel, and if Im not mood, I just sleep,
Or making something good.

PERSONAL EVALUATION
What make you different from others?
I focused to something I do

What would you consider need to be improved in yourself?

How I can discipline, how I make someone proud about my speech, how I can give my heart
With a faith, and how I can make other people love me with I do.

Would you like to participate in all programs provided during 1 year ?

V

YES

NO

How do you know about Astra 1st Program ?

University information board
Friends / relatives
www.astra.co.id
other internet (facebook, email, mailing list, ......................)

Jakarta, ., 2011

(_______________________)

Facebook: Astra Community

Twitter: AstraCommunity
Email: astra1st@astra.co.id

Signature & Full name

ASTRA, a world of opportunities

ACHIEVEMENT
Personally, what is your greatest achievement(s), how do you accomplish it and why would you
consider it as your greatest achievement(s)
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ASTRA, A WORLD OF OPPORTUNITIES

MOTIVATION & PERSONAL STRENGTH

Explain to us, what is your biggest motivation(s) to join this program and why we need to choose
you as one of Astra 1st candidates.
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