EMPLOYMENT APPLICATION FORM

[就业登记表]

Date [日期] : Photo[照片]

Position Applied
[求聘岗位]

Please fill in completely and truthfully (USE BLOCK LETTERS)

[请如实填空和用大写字母]

PERSONAL DATA [个人信息]

FULL NAME [姓名] :

PLACE, DATE OF BIRTH [出生地点， :
出生日期]
PERMANENT ADDRESS [地址] :

CURRENT ADDRESS [通讯住地] :

GENDER [性别] MALE [男] HEIGHT [体高] : BLOOD TYPE [血型] : A AB

FEMALE [女] WEIGHT [体重] : : B O

MARITAL STATUS [婚姻状况] : SINGLE[单身] MARRIED[已婚] OTHER [其他]

RELIGION [宗教] : NATIONALITY [国际] :

ID NUMBER : PHONE NUMBER :

[身份证/公民正号码] [电话]
NPWP NUMBER : CELLULAR NUMBER :
[税号码] [手机电话]
BNI ACCOUNT : EMAIL :
[BNI 银行卡账户] [邮箱地址]
BPJS LABOUR NUMBER : DRIVER LISENCES A :
[社保险账号] [驾驶执照]
BPJS HEALTH NUMBER : C :
[医疗保险账号]

ALTIRA BUSINESS PARK, JL. YOS SUDARSO KAV. 85 SUNTER JAYA, TANJUNG PRIOK,
JAKARTA UTARA, DKI JAKARTA, 14350
EMAIL: hr.jntstar@gmail.com
FORMAL EDUCATION [学历]

YEAR [年级] GRADUATED/

NAME OF SCHOOL NOT
SCHOOL [学校] CITY [城市] MAJOR [专业] FROM [从] TO [到]
[学校名称] GRADUATED
[毕业/非毕业]
ELEMENTARY
[小学]

JUNIOR HIGH
SCHOOL
[初中学]
SENIOR
HIGHSCHOOL
[高中学]
DIPLOMA
[文凭学]
BACHELOR
[本科学]

MASTER
[研究生]

NONFORMAL EDUCATION [非正式教育]

DURATION FINANCED BY
SUBJECT [学科] INSTITUTE [学院] CITY [城市]
[持续时间] [支持者]

ACHIEVEMENT [成就]

SUBJECT [成就科目] YEAR [年]

ALTIRA BUSINESS PARK, JL. YOS SUDARSO KAV. 85 SUNTER JAYA, TANJUNG PRIOK,
JAKARTA UTARA, DKI JAKARTA, 14350
EMAIL: hr.jntstar@gmail.com
SOCIAL ACTIVITIES [社交活动]
TYPE OF ACTIVITIES INSTITUTION NAME PERIOD [期间]
ROLE [岗位]
[活动类型] [机构名称] FROM[从] TO [到]

FOREIGN LANGUAGES [外语]

Give check mark (√) in the suitable box
LISTENING [听力] SPEAKING [口语] WRITING [写作]
LANGUAGE
GOOD FAIR BAD GOOD FAIR BAD GOOD FAIR BAD
[语言] [非常好] [很好] [足够] [非常好] [很好] [足够] [非常好] [很好] [足够]
ENGLISH [英文]
MANDARIN [中文]

OTHER SKILL [其它技能]

SKILL TYPE [技能类型] SCORE (1-10) [分数]
Microsoft Office

ADDITIONAL INFORMATION [附加信息]

QUESTION [提问] EXPLANATION [说明]
Please state your career vision or plan in 5 years
ahead [请说明您未来 5 年后的职业愿景或计划]

Self weakness (please state 3 dominant factors) ?

[请解释您的三种缺点]

Self strength (please state 3 dominant factors) ?

[请解释您的三种优点]

Hobby and Interest (please state 3 hobby or

interest)
[您的三个爱好或者兴趣]

ALTIRA BUSINESS PARK, JL. YOS SUDARSO KAV. 85 SUNTER JAYA, TANJUNG PRIOK,
JAKARTA UTARA, DKI JAKARTA, 14350
EMAIL: hr.jntstar@gmail.com
FAMILY BACKGROUND [家庭背景]
Including Yourself

FAMILY CARD NUMBER

[户口号码]

LAST OCCUPATION [职业]

FAMILY MEMBER NAME AGE M/F
EDUCATION POSITION COMPANY
[家庭成员] [姓名] [年龄] [性别]
[学历] [岗位] [公司名称]
FATHER
[父亲]
MOTHER
[母亲]
BROTHER/SISTER
[兄弟/姐妹]
BROTHER/SISTER
[兄弟/姐妹]
BROTHER/SISTER
[兄弟/姐妹]
BROTHER/SISTER
[兄弟/姐妹]
BROTHER/SISTER
[兄弟/姐妹]

LAST OCCUPATION [职业]

FAMILY MEMBER NAME AGE M/F
EDUCATION POSITION COMPANY
[家庭成员] [姓名] [年龄] [性别]
[学历] [岗位] [公司名称]
SPOUSE
[配偶]
CHILDREN 1
[子女]
CHILDREN 2
[子女]
CHILDREN 3
[子女]
CHILDREN 4
[子女]

ALTIRA BUSINESS PARK, JL. YOS SUDARSO KAV. 85 SUNTER JAYA, TANJUNG PRIOK,
JAKARTA UTARA, DKI JAKARTA, 14350
EMAIL: hr.jntstar@gmail.com
WORK EXPERIENCES [工作经验]
Period [期间] Number of
Company Name / Type of Last Position /
From To Employee
Location Business Department
(Month/Year) (Month/Year) [员工人数]
[公司名称/地点] [业务类型] [岗位/部门]
[从（月/年）] [到（月/年）]
/ /
Job
Description
[职位描述]
Last Salary
[最后工资]
Reason of
Resignation
[辞职原因]

Period [期间] Number of

Company Name / Type of Last Position /
From To Employee
Location Business Department
(Month/Year) (Month/Year) [员工人数]
[公司名称/地点] [业务类型] [岗位/部门]
[从（月/年）] [到（月/年）]
/ /
Job
Description
[职位描述]
Last Salary
[最后工资]
Reason of
Resignation
[辞职原因]

Period [期间] Number of

Company Name / Type of Last Position /
From To Employee
Location Business Department
(Month/Year) (Month/Year) [员工人数]
[公司名称/地点] [业务类型] [岗位/部门]
[从（月/年）] [到（月/年）]
/ /

Job
Description
[职位描述]

Last Salary
[最后工资]
Reason of
Resignation
[辞职原因]

ALTIRA BUSINESS PARK, JL. YOS SUDARSO KAV. 85 SUNTER JAYA, TANJUNG PRIOK,
JAKARTA UTARA, DKI JAKARTA, 14350
EMAIL: hr.jntstar@gmail.com
Give check mark (√) in the correct response box

QUESTION YES NO REMARKS

[提问] [是 ] [不 ] [备注]
Have you previousely applied to our company? If so,
When and what position?
[您是否已经以前申请过我司？如果是这样，什么时
候和什么位置？]
Are you also applying to other companies? If yes,
Please mention companies and position applied?
[你还在申请其他公司吗？如果是，请提及公司和职
位申请？]
Are you tied with any contract agreement with other
company
[您是否与其他公司签订了任何合同协议？]
Do you have any object if we contact your previous
employed for reference checking?
[如果我们联系您以前的雇主进行参考检查，您有任
何问题吗？]
Do you have any acqusaintance(s) employed by our
company? Please mention name and your relationship
[您们有我们公司的熟人吗？请提及姓名和您的关系]
What illness/ surgenes/ accident have you ever had?
When have you had it?
[你有过什么严重的疾病/喘息/事故？什么时候发
生？]
Have you ever undergone any psychological test
before? If so, When, Where, and For What purpose?
[你以前经历过任何心理测试吗？如果是，请解释什
么是时间，地点，目的]
Have you ever been involved in any administrative,
civil, or criminal case?
[您是否参与过任何行政，民事或刑事案件？]
If accepted, Do you agree to be out of Jakarta sent on
assignment?
[如果被接受，您是否同意离开雅加达派出工作？]
Contact person in emergency situation (Stated names,
telephones and relation)
[紧急情况下的联系人（说明地点，电话和关系）]
Describe any kind of jobs that you like
[描述您喜欢的任何类型的工作 ]
Describe any kind of jobs that you do not like
[描述您不喜欢的任何类型的工作] ]
Please state salary and facilities that you desired
[请说明您想要的薪水和设施] ]
If accepted, When can you start working?
[如果被接受，你什么时候开始工作]

ALTIRA BUSINESS PARK, JL. YOS SUDARSO KAV. 85 SUNTER JAYA, TANJUNG PRIOK,
JAKARTA UTARA, DKI JAKARTA, 14350
EMAIL: hr.jntstar@gmail.com
I hereby certify that this information given above is completely true and if under any circumstances, any
misrepresentation of information is found, I shall fully be held responsible for the consequences.

[我在此证明上述信息完全正确。如果在任何情况下发现任何歪曲信息，我将对后果承担全部责任]

Jakarta, …... /………………… 2019

__________________________

Name : …………………………………….

ALTIRA BUSINESS PARK, JL. YOS SUDARSO KAV. 85 SUNTER JAYA, TANJUNG PRIOK,
JAKARTA UTARA, DKI JAKARTA, 14350
EMAIL: hr.jntstar@gmail.com