ASTRA, a world of opportunities

APPLICATION FORM
Astra Leadership Development Challenge
PERSONAL IDENTITY
Full Name: Place & Date of Birth: Address:

3x4 photograph

Email: Phone Number: Mobile: EDUCATION BACKGROUND High School : University: Faculty: Major: Expected time of graduation (month and year):

GPA: Semester: Credits have been taken:

SPECIAL COURSE / TRAINING ATTENDED:

Year Course / Training Place / Insitution Remark

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) Year Activities / Organization Organization Scope Position Held Responsibilities

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

Year Company Position Held Responsiblities

ACHIEVEMENT
Please mention award(s) you have been received and explain it briefly (academic honors, distinction, scholarship, etc) Year Award Institution Remarks

ASTRA, a world of opportunities

INTEREST What do you usually do in your spare time?

PERSONAL EVALUATION What make you different from others? .

What would you consider need to be improved in yourself? .

What is your motivation for join this program?

Would you like to participate in all programs provided during 1 months ? (YES / NO ) ..

How do you know about Astra Leadership Development Challenge ?

(University information board / Friends / relatives / facebook) .. *Leader is not a position, but leader is an action. It called servant leadership. Astra 1st UGM-