Professional Documents
Culture Documents
: FOR05/PRO02/STA06/SPMI-UPH
SISTEM PENJAMINAN MUTU INTERNAL Revisi : 02
Photograph
4 X 6 cm
A. Data Pribadi
Personal Data
3. Kewarganegaraan : _________________________________
Nationality
4. Agama : _________________________________
Religion
LISAN TERTULIS
Bahasa Asing
No. Spoken Written
Foreign Language
Good Average Poor Good Average Poor
1.
2.
3.
2. Pendidikan formal
Formal Education
Tahun Tahun
Tingkat
Nama Sekolah Masuk Lulus Gelar Spesialisasi
Pendidikan IPK
Name of School Year of Graduation Title Specialization
Level of Education GPA
Join Year
Elementary
Jr. High School
Sr. High School
Diploma
University – S1
Profession
Master Program
Specialist 1
Specialist 2
Dr/PhD Program
3. Latihan / Kursus
Training Courses
4. Prestasi khusus
Special achievements
C. Anggota Organisasi
Professional Affiliations / Memberships
F. Data Keluarga
Family Data
Tgl. Lahir
Nama Hubungan Pekerjaan Nama Perusahaan
No. Date of
Name Relationship Occupation Name of Company
Birth
1.
2.
3.
G. Kesehatan
Health
Apakah Anda pernah memiliki riwayat kesehatan yang mengharuskan Anda dirawat di Rumah Sakit atau
mendapat perawatan khusus yang cukup lama?**
Have you had a medical history of getting hospitalized? Do you currently have or had any long term
treatments? **
□ Ya, Jelaskan : _____________________________________________________________
Yes, Please describe _____________________________________________________________
_____________________________________________________________
□ Tidak
No
**) Beri tanda centang (√) pada pilihan yang sesuai
Please tick (√) appropriate box
H. Referensi
Reference
Lama
Nama Hubungan Kenal Pekerjaan No. Tlp
No. E-mail
Name Relationship Years Occupation Telephone
Known
Jika sudah bekerja
If you have work experience
Atasan
1.
Supervisor
Teman kerja
2.
Co-worker
Anak buah
3.
Subordinates
Pendeta
4.
Pastor
5.
Lama
Nama Hubungan Kenal Pekerjaan No. Tlp
No. E-mail
Name Relationship Years Occupation Telephone
Known
Jika belum pernah bekerja
Fresh graduate
Pembimbing
Skripsi
1. Thesis
Advisor /
Supervisor
Pendeta
2.
Pastor
Apakah sebelumnya Anda pernah melamar kerja pada unit di bawah naungan Yayasan Pendidikan Pelita
Harapan?**
Have you ever applied to unit(s) under Pelita Harapan Educational Foundation before? **
□ Ya, Mohon jelaskan tempat, posisi, dan tanggal melamar
Yes, Please describe place, position, and date when applied
_______________________________________________________________________________
_______________________________________________________________________________
□ Tidak
No
Dari manakah Anda mengetahui adanya informasi mengenai lowongan pekerjaan di institusi kami?**
Where did you get the information of the job opportunities at our Institution? **
□ Jobportal (Jobstreet) □ Jobportal (JobsDB) □ Media Social WhatsApp
□ UPH Website □ Poster/Flyer □ Jobfair
□ Keluarga/Saudara □ Teman □ Lain-Lain: ……………..
Family Friend Others
*) Coret yang tidak perlu **) Beri tanda centang (√) pada pilihan yang sesuai
Cross the irrelevant one Please tick (√) appropriate box
True Knowledge, Faith in Christ, Godly Character
UNIVERSITAS PELITA HARAPAN No. Dok. : FOR05/PRO02/STA06/SPMI-UPH
SISTEM PENJAMINAN MUTU INTERNAL Revisi : 02
I. Waktu
Date of commencement
Jika lamaran Anda diterima, berapa lama waktu yang Anda perlukan untuk bergabung dengan kami?
When will be your earliest convenience date to join UPH?