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ASTRA, dunia kesempatan

FORMULIR PERMOHONAN
Astra 1st Program

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IDENTITAS DIRI
Nama :
Tempat& Tanggal Lahir:
Alamat:

Email:
Nomor Telepon Rumah:
Ponsel:
LATAR BELAKANG PENDIDIKAN
Sekolah Tinggi :
Universitas:

GPA:

Fakultas:

Semester:

Jurusan:

SKS Yang Telah Diambil:

Judul TGA : (Jika Ada)

Judul Waktu Lulus (Bulan Dan Tahun):


KURSUS KHUSUS / PELATIHAN YANG DIIKUTI:
Tahun

Kursus/Pelatihan

Tempat / Institusi

Ucapan

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ASTRA, dunia kesempatan


EXTRA KULIKULER
(Kegiatan organisas yang pernah anda ikuti dalam waktu maksimun 2 tahun dan kontribusi
yang anda berikan)
Tahun

Aktifitas /
Organisasi

Organisasi
Cakupan

Jabatan

Tanggungjawab

PENGALAMAN KERJA
Tahun

Perusahaan

Jabatan

Tanggungjawab

PENGHARGAAN KHUSUS
Penghargaan (s) Yang Anda Terima (Penghargaan Akademik, Beasiswa,dll)
Tahun

Penghargaan

Lembaga

Ucapan

ASTRA, dunia kesempatan


PERTANYAAN
Apa yang biasa anda lakukan di waktu luang?

EVALUASI PRIBADI
Apa yang menbuat anda berbeda dari orang lain?

Apa yang Anda anggap perlu diperbaiki dalam diri Anda?

Apakah Anda ingin berpartisipasi dalam semua program yang diberikan selama 1 tahun?
YA

TIDAK

Apa yang anda ketahui tentang Program 1st Astra?


Papan InformasiUniversitas
Teman/Kerabat
www.astra.co.id
Internet (facebook, email, daftar surat ......................)
Jakarta, ., 2012
Facebook: Astra Community
Twitter: AstraCommunity
Email: astra1st@astra.co.id

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Nama & Tanda Tangan

ASTRA, dunia kesempatan


PRESTASI
Secara pribadi, apa prestasi terbesar anda (s), bagaimana Anda mencapainya dan mengapa Anda
mengaggap itu sebagai prestasi terbesar Anda (s)
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ASTRA, DUNIA KESEMPATAN

MOTIVASI DAN KEPRIBADIAN


Jelaskan kepada kami, apa motivasi terbesar anda (s) untuk bergabung dengan program ini dan
mengapa kita perlu memilih Anda sebagai salah satu Astra 1 kandidat.
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