indersigned below apply for On the Job Training and willing to follow and comply on every procedures and rules that is applied in Hotel and Batam Tourism Polytechnic. Name YOGI SAPUTRA ‘Student Number 2019030054 Passport & ID Card Number + 2105071810010001 ‘Study Program : Culinary Management Hotel ‘Sheraton Hotel & Towers Bandung OJT Program Kitchen/Pastry Period Januari 2021 — Juni 2021 Batam, 17 October 2020, | Known by, Proposed by, Head of Study Program Student, ie ea ‘ogi Saputra ‘SN: 2019030054“Homie ADoRESS / Avaar ‘Asrama (BTP) ,Tiban Ayu, sekupangBatam, KEPRI ® Kitchen division 4 Pastry Division Restaurant Division O Bar Division Front Office Division DD Housekeeping Other .F&B Service eee oi “Format EDUCATION / PenovoikaN Fonwai POSTON PRACTICAL TRAINING DESIRED (max. 2 divisions in 1 Department Head) (No. Texp0n RuMAn, ‘School/Academy/University Sekoloh/Akodemi/Universitas ‘SD NEGERI 001 AIR ASUK SMP NEGERI 1AIR ASUK ‘SMA NEGERI 1 SIANTAN ‘BATAM TOURISM POLYTECHNIC ‘Ability Certificate Score(if any) ___Kemampuan iol Serifikat (ikea ada} —_| English © fair O Fluent } Bahasa inggris Bose lancar Mandarin ae Fair “TO Fluent T ‘Bahasa Mandarin Biase Lancor ‘Other Languages | O Fuent i Phy nea Bahasa Lainnya Biaso | toncer Year ] Place Tatun 2019 2019ME Hotel sis is your health? Bagaimana kesehatan anda? M txcelient | 1) Good Sangat Baik | Baik Do you have any physical disability? Eg. Limbs, Sight, Hearing, etc D_ Yes, please explain No ‘Adakah anda mengalami cacat fk? Ya, tolong jelaskan Tidak Seperti lumpuh, cacat penglihatan, pendengaran, ae RABUN JAUH ¥ Have you ever had any operations or serious disease? O Yes, please explain Bn Apakah anda _pernah__menjaloni operasi| Yo, tolong jelaskan Tidak pembedahan atau mengidap penyakit serius? Bo you suffer from any disease that requires : 5 medication? D_ Yes, please explain H No Adakoh onda mengidap seborang penyakit yang | Yo, tolong jelaskan Tidak ‘memerlukon obat-obatan? \ ‘Are you pregrant? O Yes, please explain B No ‘Apakah anda sedang mengondung? Yo, tolong jelaskon Tidak Famty / Ketuanca Name Relationship Home Address Phone /Mobile Nama Hubungan | Alamat Rumah _Telepon/Ponse! ‘Muspandi Orang Tua Teluk Buluh 082268145849 Fatmawati Orang Tua Teluk Buluh 082268145841 Mustafa Kamal Wall ‘Astama Batam Tourism Polytechnic 085356755732 DECLARATION /PEnnVATAaN HEI Hencoy DECLARE THAT THE INFORMATION GIVEN IS COMPLETE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. | [REAUZE THAT ALL MATERIALS SUBMITTED IN SUPPORT OF MY APPLICATION FOR ADMISSION BECOME THE PROPERTY OF YOUR, HOTEL. | AM AWARE THAT ANY MISREPRESENTATION OR MISSION OF FACTS IN MY APPLICATION WILL JUSTIFY THE DENIAL OF ADMISSION, THE CANCELLATION OF ADMISSION OR EXPULSION. ‘Dengan ini saya menyatakan dengan sesungguhnya bahwa semua informas! yang saya sampaikan dalam dokumen ini adoloh benar dan akurat. Saya menyadari bahwa semua dokumen yong saya gunakan untuk _menunjang aptikes! pendaftaran ini menjadi miik hotel, Apobita diketemukan penipuar/pemalsuan atas informasi | na saya sampaikan, saya bersedadikenakan sank.