CANDIDATE INFORMATION FORM SHARIA OFFICER DEVELOPMENT PROGRAM (SODP)

Picture Pass)ort Si*e

PERSONAL DETAILS
Full Name Sex Place, Date of Birth Religion Ethnic Marital Status
Current Mailing Address: Permanent Mailing Address:

el! No! "#ff$ "Res$ "%P$ E&mail:

el! No! "#ff$ "Res$ "%P$ E&mail:

ACADEMIC INFORMATION
From To Schools, Colleges, !"#ers"$"es M%&or GPA D"'lom%
"'es(No$

(OR)ING E*PERIENCE
* Fill from current, previous to first position
S$%r$ D%$e E!1 D%$e Com'%!/ Pos"$"o! 0o, Descr"'$"o! (I! 1e$%"l)

RE+ IRED INFORMATION

Are +ou ,illing to -e relocated in an+ unit of BR.S+ariah ,ithin .ndonesia/ 'es No

Are +ou ,illing to undergo #fficial Bond ".0atan Dinas$ ,ith BR.S+ariah and to undergo )ro-ation )eriod/ 'es No

est for 1ualified candidates ,ill -e held in some c"$"es ,elo-! Please select the test location +ou )refer "Pic0 one$: 2a0arta 2og3a0arta Medan Sura-a+a Ma0assar

ADDITIONAL INFORMATION
SPECIAL ACTIVITIES (ORGANI.ATIONS, TRAININGS, SEMINARS, e$c)
From To N%me o2 Org%!"3%$"o! Pl%ce Pos"$"o!

LANG AGE S)ILLS

L%!g6%ge Re%1"!g (r"$"!g S'e%7"!g !1ers$%!1"!g

No$es5

E 4 Excellent,

G 4 5ood,

F 4 Fair,

P 4 Poor

OTHER PERSONAL INFORMATION

Com)uter Proficienc+ #ther S0ills 7 ex)ertise "Program(6anguage: $

FAMIL4 DETAILS
Rel%$"o!sh"' N%me Age L%s$ E16c%$"o! Occ6'%$"o!

Father Mother %us-and(8ife Child

Brothers(Sister

'ou ha9e ::::::::::::-rother"s$(sister"s$ and are the :::::::::::::::child in the famil+!