APPLICANT DATA FORM

IDENTITY
KTP No. : SIM No.
Fullname : Email
Nickname : Sex :M/F
LinkedIn account : ____________________ Facebook account: ______________________Instagram:
Address :
Address as in KTP :
Phone : Email: Mobile phone:
Place and Date of Birth : / Religion:
Marital Status : Single / Married / Widowed Nationality

MEDICAL CONDITION
Blood Type : A / B / AB / O Rhesus: +/- Allergy
Accident experienced : Smoking : Yes / No
Ongoing health treatment :

FORMAL & INFORMAL EDUCATION

School Year
Degree Name of School Address Major Result
From To
Primary School
Junior High School
Senior High School
Academy
University
Others

SPECIAL ABILITY
Foreign Language that are Mastered Proficiency Test Score Ability / Skills that are mastered (sports/arts/etc) Info
PARENTS & HUSBAND/WIFE'S DATA
Phone
Relation Name DoB Education Address Name of office Address of office Job
Number
Father
Mother
Father in law
Mother in law
Husband/Wife

SIBLINGS' Data
Phone
Sibling Name DoB Education Address Name of office Address of office Job
Number
Older/Younger
Older/Younger
Older/Younger

CHILDREN'S DATA
Date of Level/
Name Address Name of School Address of School
Birth Class

WORK EXPERIENCES IN THE LAST 10 YEARS

Job length Name and Address of Contact of Position of
Position/Division Phone Job Description References
Since To prior workplace referrence refference

Why do you leave your last job?

Why do you want to join CIKAL?

Briefly tell us what do you know about this job.

How much is your last salary?

What kind of subsidiary do you get in the last job? (if any)

How much is your expected salary in Cikal? (must be filled)

What kind of subsidiary that you expect from CIKAL?

PERSONALITY

What kind of problems that you usually face in interacting with children?

Do you have strategy in facing children?

Tell us your hobbies or the things you do in your spare time?

What kind of books do you like to read?

When is the last time you read book?
Tell the last book titles and the authors you had read or, the one you're reading right now.

Do you like travelling? Yes No

Tell all the cities that you've visited (domestic and foreign)

Tell us in brief, what is your goals in the next 5-10 years and why join Cikal can help you to achieve your goals.

Tell us your strengths and how it would help our organization grow.

OTHERS
Have you ever join any social services or voluntary activities? Yes No
If the answer is yes, tell us when, name of organization, job and division in that activity.

Do you available to work in weekend schedule? Yes No

Are you willing to undergo an official service bond for the first 2 years? Yes No

From where did you find out information about the vacancy? Cikal's website Online job posting Broadcast message Cikal's staff
Friends/colleague Social media LinkedIn

The one who signed below tells that all the information that have been written above is true.
Jakarta, _________________________

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