APPLICATION FORM

POSITION CODE:

* Please fill in the form in English

Full name :
Place/Date of Birth :
Address :
Email :
Phone Number :

University Faculty Major Year (From/To) Degree GPA

S2/S1/D3
S2/S1/D3

Course/Training Address Course/Training Address

Organization/Extracurricular Address Position Year (From/To)

Language Poor Good Fluent Language Poor Good Fluent

1. English 2.
Internship Experience:
1. Company Name Position Year (From/To) Salary Reason of Leaving

Describe your work responsibility:

Target:
Working Experience:
1. Company Name Position Year (From/To) Salary Reason of Leaving

Describe your work responsibility:

Target:

2. Company Name Position Year (From/To) Salary Reason of Leaving

Describe your work responsibility:

Target:

Expected salary : Rp.

Why do you want to apply for that position?
Are you willing to be assigned outside Jakarta? Willing Not willing
Strength :
Weakness : ……………..…, ..…………………………

I declare that all the information given is true. I am willing to withdraw from the
recruitment process if any of the statement is incorrect.