TMMI Form

Nama : No. KTP : No. Registrasi : __________2020

Notes for Applicants

1. Please tick “√” where applicable and complete every item in BLOCK LETTER in black or
blue ink.
ID Member AI
2. Please Ensure that all parts in the form are completed and the information is accurate.
3. The personal data provided in this form will be used for recruitment and other
employment-related purpose only.

OWNED VEHICLE SUV TMMI

PICANTO

AVANZA

Area member
□ Jakarta （□ Bogor □ Bekasi □ Bandung □ Lainnya
□ Id & Tahun

□ Referensi □ Pribadi Nama referensi

□ Toyota group □ Daihatsu group □ Isuzu Group

Personal Member
Nama
Name Sex □ Male □ Female
Panggilan

Status Height Weight Blood Type

CM KG

Tanggal daftar Bulan Tahun

Tempat
Postal Code
Tinggal

Domisili Postal Code

Alamat kantor Postal Code

Telepon E-Mail Mobile

Date of Birth Age Native Place Place of Birth

ID Card Number Nation

*Incase of emergency, please inform the following person

Name Relation Telephone

Family Data
Your Marital Status
□ Single □ Married □ Widowed □ Separated □ Divorced

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 Name Relationship Age Working Company/Position Telephone

ZIC-Staffing-0003-TEMP
Higher Education & Professional Qualification

Degree School Time Period Subject Qualification Obtained

Training

Organization Time Period Content Qualification

Employment Record
Are you working now? If yes, your company is:
□ Yes □ No
The most recent employer details From（YYYY/MM/DD） To（YYYY/MM/DD）

Company Company
Industry
Name Size
Company
Department Job Title
Type
Basic Salary Annual Bonus
Package
Allowance Stocks Option

Reason for Leaving Reference

The most but one recent employer details From（YYYY/MM/DD） To（YYYY/MM/DD）

Company Company
Industry
Name Size
Company
Department Job Title
Type
Basic Salary Annual Bonus
Package
Allowance Stocks Option

Reason for Leaving Reference

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Other Employer Details

Department & Salary/ Reason for

Employer Name Work Period
Position M Leaving

Are you still under employment by any company? Certification Employment

□ Yes □ No □ Yes □ No

Language, computer & other ability

Please tick “√” in the Listen Speaking Reading Written
appropriate boxes. Fluent Good Poor Fluent Good Poor Fluent Good Poor Fluent Good Poor

Chinese
Languages

Cantonese

English

Japanese
IT Skills

Microsoft Windows □ Expert □ Familiar □ Basic Other, Please Specify ：

Microsoft Word □ Expert □ Familiar □ Basic

Microsoft Excel □ Expert □ Familiar □ Basic

Microsoft PowerPoint □ Expert □ Familiar □ Basic

If you have any other skills, Please Specify.

Other Information
Please answer the following question honest. If yes, please specify the details.

Are you had any serious illness or genetic diseases? □ No □ Yes （If yes, Please Specify）

Are you had any criminal record or administrative execution? □ No □ Yes （If yes, Please Specify）

May we ask your present(before) employer for references regarding your qualifications and
□ Yes □ No
conduct?

□ No □ Yes （ If yes, Please

Specify）
Are you acquainted with any person presently employed with 5 Elements?

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 Name Position Acquaintance Time

Relationship

Attachment

1. Hard Copy of the Resident Identity Card

正面 Front 背面 Back

Declaration
I hereby affirm that information given on this application for employment is complete and accurate. I
understand that any falsification or commission will be immediate grounds for dismissal without receiving
any financial compensation. I authorize the company to investigate the authenticity of above-mentioned
materials.

Signature of Applicant：

Date ：

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