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  • Application Form (Email Ver)

    Uploaded by

    Dimas Mahendra Kusuma
    8 views10 pages
    This document appears to be a job application form for the position of Jakarta Plan. It requests personal information such as name, address, family details, education history, work experience, computer skills, references, and hobbies. The applicant is asked to provide details including their full name, photo, contact information, family members, educational qualifications, work history with past employers, positions held and salaries, computer skills, references, availability date, and reason for leaving previous roles. It certifies that the information provided is true and authorizes the company to conduct reference checks and take disciplinary action if any information is found to be false.

    Original Description:

    APLIKA FORM

    Copyright

    © © All Rights Reserved

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    XLSX, PDF, TXT or read online from Scribd

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    This document appears to be a job application form for the position of Jakarta Plan. It requests personal information such as name, address, family details, education history, work experience, computer skills, references, and hobbies. The applicant is asked to provide details including their full name, photo, contact information, family members, educational qualifications, work history with past employers, positions held and salaries, computer skills, references, availability date, and reason for leaving previous roles. It certifies that the information provided is true and authorizes the company to conduct reference checks and take disciplinary action if any information is found to be false.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    8 views10 pages

    Application Form (Email Ver)

    Uploaded by

    Dimas Mahendra Kusuma
    This document appears to be a job application form for the position of Jakarta Plan. It requests personal information such as name, address, family details, education history, work experience, computer skills, references, and hobbies. The applicant is asked to provide details including their full name, photo, contact information, family members, educational qualifications, work history with past employers, positions held and salaries, computer skills, references, availability date, and reason for leaving previous roles. It certifies that the information provided is true and authorizes the company to conduct reference checks and take disciplinary action if any information is found to be false.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 10

    Jakarta Plan

    APPLICATION FORM

    Private & Confid

    POSITION APPLIED

    Photo
    3X4

    PERSONAL DATA
    Full Name

    (in capital)

    Nick Name

    Blood Group

    Place / Date of Birth

    Height

    cm

    Sex

    Weight

    kg

    Status

    Eyes

    Date of Married

    Identity Card No.

    Issued at/Date :

    Passport No.

    Issued at/Date :

    Home Address

    personal ho

    parents hou

    rental house

    Phone number

    Single / Marriage / Widower / Widow

    Office : 62 -

    Extention :

    Home : 62 -

    Handphone :

    E-mail address

    Permanent Address

    (as per Identity Card) :


    :
    Phone number

    Driving License (SIM)

    62 -

    not available SIM-A


    SIM-C

    SIM-B1

    SIM-B2

    certificate for driving heavy equipment

    Please give brief details of any serious nature disabilities/illness operations/ allergies :

    Please give brief details of any previous conviction (include traffic offenses) :

    Are you willing to have a medical check ?

    glasses / not

    YOUR FAMILY
    Name

    Sex Place/Date of Birth Education

    Work at

    Home Addres

    Parents
    1
    2
    continue

    Doc. No. : HWI004/A

    Page 1 of 4

    YOUR FAMILY (if unsufficient space, please write other page)


    Name

    Sex

    Status Place/Date of Birth Education

    Work at

    Home Addre

    Work at

    Home Addre

    Brothers/Sisters (in chronological order)


    1
    2
    3
    4
    5
    6

    Your position is No. ..................................


    Name

    Sex

    Status Place/Date of Birth Education

    Husband/Wife
    Children
    1
    2
    3
    4

    From

    To

    or Institution

    Qualification/ Field of Study Certified


    Trade

    Speaking

    La
    n
    g

    Years Attended Name of School Town/City

    u
    ag
    e

    EDUCATIONAL HISTORY & LANGUAGE PROFICIENCY


    Yes / No

    F P

    Indonesia
    English
    Others :

    Note : G=Good, F=Fair, P=

    INFORMAL EDUCATION (Courses & Training)


    Type/Topic of Courses or Training

    Organizer name

    Year of attend

    Certifie

    Yes / N

    COMPUTER SKILLS
    Type of Program

    Name of Program

    Grade (Good/F

    Page 2 of 4

    WORKING EXPERIENCE (if unsufficient space, please write in other page)


    Company name, address & phone number

    Type of company

    Name of direct report

    Salary

    Benefit : transport

    :
    :
    :

    meals
    insurance

    Reason of leaving

    Name of direct report

    Salary

    Benefit : transport

    :
    :
    :

    Reason of leaving

    Ending

    Starting

    Ending

    Nett/gross

    car / bus/ allowance _________


    provided / allowance _________

    Type of company

    insurance

    Starting

    Position

    Main Job :

    Company name, address & phone number

    meals

    Date

    Date
    Starting

    Position
    Ending

    Starting

    Ending

    Main Job :

    Nett/gross

    car / bus/ allowance _________


    provided / allowance _________

    Company name, address & phone number

    Date
    Starting

    Position
    Ending

    Starting

    Ending

    Type of company

    Name of direct report

    Salary

    :
    :
    :
    :

    Benefit : transport
    meals
    insurance

    Main Job :

    Nett/gross

    car / bus/ allowance _________


    provided / allowance _________

    Reason of leaving

    Please draw your present or last organization chart and indicate your position.

    Page 3 of 4

    If you still employee, please explain the reason why you wish to leave your present organization.

    Why do you want to joint with our organization ?

    What is your monthly salary expectation ? (gross due to tax)


    Salary

    On what date would you be able to commence joint with our organization ?

    REFERENCES (if available and not relatives)


    No

    Name

    Job/position

    Address/phone

    Relation

    1
    2
    RELATIVES or ACQUAINTANCES (if available in our organization)
    No

    Name

    1
    2
    EXTERNAL ACTIVITIES

    Job/position

    Address/phone

    Relation

    No

    Year

    Name of Organization

    Position

    HOBBIES and SPORT


    No

    Hobbies / Sport

    Year

    I certify that the above information is true and I agree the company taking disciplinary actio
    against me if any information is found false and I allow the company to do reference check
    Jakarta

    (.................................................................
    Name
    Page 4 of 4

    Jakarta Plant

    Private & Confidential


    Photo
    3X4

    asses / not

    personal house
    parents house
    rental house

    Home Address

    . No. : HWI004/A3(1)

    Home Address

    ag
    e

    Home Address

    Writing
    G F

    Good, F=Fair, P=Poor

    Certified
    Yes / No

    Grade (Good/Fair)

    on
    Ending

    on
    Ending

    on
    Ending

    organization.

    Relation

    Relation

    Position

    Year

    sciplinary action
    erence check.

    ......................)

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