PT BEIERSDORF INDONESIA

APPLICATION FORM

Instructions :
The form should be completely filled in and “N.A” written where applicable

POSITION APPLIED FOR :

Procurement Staff

Permanent – Full time employee v Internship

Contract Employee Others

Part Time Employee

Mr. David Gaudensius David Nick Name

Taman Semanan Indah Blok B3/35, Cengkareng, West Jakarta

Home Address

NAME & ADDRESS

PERSONAL DETAILS

ID No (KTP) Driver License No. (SIM) Passport No. Tax No. (NPWP)

3173060110930006 93011205121000233 85.349.523.2-085.000

Jamsostek No. Birth Place & Birth date Age Gender (Male/Female)

18023765615 Jakarta, 1 October 1993 26 Male

Marital Status Nationality Religion Email Address

Single Indonesia Catholic david.gaudensius

@hotmail.com

* Please delete accordingly

 PT BEIERSDORF INDONESIA
APPLICATION FORM
Telephone No (Home) Telephone No (Office) Handphone/ Pager No

(021) 50597777 Ext 7046

081931331010 N/A

* Please delete accordingly

FAMILY DETAILS OF SPOUSE/CHILDREN/PARENTS/SIBLINGS

Name Relationship Date of Birth Occupation Employer

1.Fx Tjoe Eugene Father 19 November 1959 Entrepreneur

2. Maria Josephine Melawati Mother 1 Mei 1959 Doctor

Soebenoe

3.Maria Fransisca Donata Sister 19 Agustus 1989 Piano Teacher Freelance

4.

5.

6.

IN CASE OF EMERGENCY, TO CONTACT

Name Relationship Telephone (Home/Office) Handphone

Fx Tjoe Eugene Father N/A 087778585159

Daniel Brother in Law N/A 081808843210

LANGUAGE ABILITY
Spoken

Indonesian, English
Written

Indonesian, English
EDUCATION/QUALIFICATION (Start with highest educational qualification)

From (date) To (date) Name of School, College, University, etc Qualifications Obtained Country

August 2012 Jan 2017 Parahyangan Catholic University Bachelor of Engineering Indonesia

June 2009 June 2012 Canisius College Senior High School High School Indonesia

SPECIAL TRAINING COURSES

From (date) To (date) Name of Institution Qualifications/ Certification Country

Obtained

OTHER COURSES / TRAINING YOU ARE CURRENTLY PURSUING:

PRESENT MEMBERSHIP OF PROFESSIONAL, SOCIAL & SPORTING ORGANIZATION

From (date) To (date) Name of Organization Country

1.

2.

3.
EMPLOYMENT HISTORY (Start with the current or most recent employer)
From (date) To (date) Name of Employer

May 2019 Present PT SMART Tbk,

Industry Country Address & Tel No

Sinar Mas MSIG Tower

Palm Oil Manufacturer Indonesia Jl. Jend. Sudirman No.Kav. 21, RT.10/RW.1, Kuningan, Karet,
Kecamatan Setiabudi, Kota Jakarta Selatan, Daerah Khusus Ibukota
Jakarta 12920
(021) 50597777
Position Held Monthly Salary (start) Monthly Salary (end)

Procurement Staff Rp 9.000.000 Rp 9.000.000

Supervisor’s Name Supervisor’s Position Reasons for leaving

Stefani Edmunda Manager Unable to develop myself, Stagnant Position

Main job responsibilities

Provide every needs from every users without ignoring the Price, Quality, and Delivery Time

From (date) To (date) Name of Employer

March 2018 May 2019 PT Prakarsa Alam Segar

Industry Country Address & Tel No

FMCG (Food) Indonesia Jl. Komp. PT. Bakr, RT.001/RW.024, Pejuang,

Kecamatan Medan Satria, Kota Bks, Jawa Barat 17131
(021) 88872348
Position Held Monthly Salary (start) Monthly Salary (end)

Purchasing Staf Rp 6.200.000 Rp 6.700.000

Supervisor’s Name Supervisor’s Position Reasons for leaving

Gabriella Noviani Supervisor Purchasing Company has no concern for their employees (lack of facility
and benefits)

Main job responsibilities

Process PR to PO, expedite PO, make sure user’s satisfaction based on quality, price and delivery time.
From (date) To (date) Name of Employer

Industry Country Address & Tel No

Position Held Monthly Salary (start) Monthly Salary (end)

Supervisor’s Name Supervisor’s Position Reasons for leaving

Main job responsibilities

From (date) To (date) Name of Employer

Industry Country Address & Tel No

Position Held Monthly Salary (start) Monthly Salary (end)

Supervisor’s Name Supervisor’s Position Reasons for leaving

Main job responsibilities

REFERENCES
May we refer to your present & past employer/s about your employment with them?
If no, please state.

Current : Diah Hidajati Devi

Past: Gabriella Noviani

SALARY

Expected Salary
Rp 10.500.000

FURTHER INFORMATION
Have you applied to PT Beiersdorf Indonesia before?
No
If so, please state dates(s) and position(s) applied for.
Do you have any friends or relatives in PT Beiersdorf Indonesia?
No
If so, please state name, position held and relationship.
Have you ever been dismissed/ terminated/ suspended from employment?
No
If so, please state reason.
Have you ever been detained, charged or convicted in any court of law?
No
If so, please state nature of offence.
Have you ever been seriously ill?
(e.g. any mental illness, physical impairment, disease or disability) No
If so, please state what illness and when.
Are you willing to be located outside Jakarta?
Yes

What is the earliest date you can start work, if successful?

Soon

How did you come to know of the vacancy?

LinkedIn
DECLARATION
I hereby declare that all the information provided by me in this form is correct and true to the best of my knowledge and that I have
not wilfully suppressed any material fact. I fully understand and accept that if at any time after it is found that a false declaration
has been made in this form, the Company has the absolute right to terminate my employment without notice.
Signature of Applicant Date

5th December 2019

FOR OFFICE USE ONLY

Recruitment Outcome : Offer / Hold / Reject / Others Cost Centre :

Pre-employment Medical Checkup and Clearance : Arranged Cleared

Salary Offering : Completed

Letter of Agreement : Completed

New Employee HRMS Setup : Completed

Income Tax Registration (if any) : Completed

Jamsostek Registration (if any) : Completed