CONFIDENTIAL

ADARO JOB APPLICATION

Position Applied : Date of Interview :

I. PERSONAL DATA

Full Name (according to ID Card) : Putra Anggara

Nick Name : Angga Gender : Male
Religion : Islam Blood Type : B
Place/Date of Birth : Duri /01/10/1996
Marital Status : Single
ID No. : 1401100110960001
Nationality : Indonesia
Mobile Phone No. : +6281316536315
Email : anggaraputra184@yahoo.com
Address According to ID Card (required)
Jl. Utama Simp. Petapahan Kec. Tapung Kab. Kampar
City: Kampar State/Province: Riau Country: Indonesia Zipcode: 28464
Home Phone No.: 081316536315
Housing Status**
Personal Relatives
Parents Rental Others: Child
Current Address (required)
Jl. Pembina No. 27, RT/14 - RW/05 Kel. Susukan, Kec. Ciracas
City: DKI Jakarta State/Province: DKI Jakarta Country: Indonesia Zipcode: 13750
Home Phone No.: 081316536315
Housing Status **
Personal Relatives
Parents Rental Others:
Emergency Family Contact Info (required)
Name :0 Home Phone No. :0
Relationship :0 Mobile Phone No. :0
Address :0

SOCIAL MEDIA UNIFORM

Facebook :0 Clothes size :
Instagram : 0 Pants size :0
Twitter : 0 Shoes size :0
Linkedin : 0 Height/Weight : 0 cm / 0 kg
Personal Blog : 0
Only filled in for positions that require uniforms.

2. FAMILY DATA
Please write your family data, including yourself. Please give (late) behind the last name if the person has been passed.

I am the of children
Family Place, Latest Education/
Name M/F Latest Occupation
Relationship Date of Birth Major
Father
Mother
Sibling 1
Sibling 2
Sibling 3
Sibling 4
Sibling 5

** Cross your choice

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If you have married, you are required to fill this table. Please give (late) behind the last name if the person has been passed.

Family Place, Latest Education/

Name M/F Latest Occupation
Relationship Date of Birth Mayor
Husband/Wife
Child 1
Child 2
Child 3

3. EDUCATIONAL BACKGROUND
A. Formal Education. Please sort from the most recent level of education.

Level of Name of School / Year

City Mayor/ Faculty GPA/ Score
Education University (Start - End)
Bachelor Universitas Muhammadiyah Prof. Engineering (Computer/ September, 2016 -
DKI Jakarta 3.10
Degree Dr. Hamka Telecommunication) August, 2020

B. Informal Education. (i.e: certification, seminar, training, workshop, course, etc.)

Certified
Name of Event Place Name of Institution Duration Year
(Y/N)
Sertifikasi Skkni Junior
Pustiknas Lsp Tik 5 Day 2018 Y
Networking

C. Competencies. (i.e: language, computer, etc.)

Competency Competency

4. ORGANIZATIONAL EXPERIENCES, ACHIEVEMENT, & SCHOLARSHIPS

A. Please write max. 3 organizational or organizing commitee experiences, that you think that you had contributed to the most.

Organizational Name
Hizbul Wathan Uhamka
Hizbul Wathan Uhamka
Ikatan Mahasiswa
Muhammadiyah
Month, Year
Organizational Level Type of Organization Position
(Start - End)
Structural Student
October, 2019 To October,
University/city/province Organization (i.e. Ketua Umum
2020
Bem, Himpunan)
Structural Student
October, 2018 To November, Ketua Bidang Pendidikan
University/city/province Organization (i.e.
2019 Dan Latihan (diklat)
Bem, Himpunan)
Ketua Bidang Hikmah
September, 2018 To
National Religious Dan Riset Pengembagan
November, 2019
Keilmuan (rpk)

B. Please write max. 2 of your most valuable achievements/honor/distinction from competitions, that had occured in the last 6 years.

Achievement Achievement Level Title Award Giver Year

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C. Please write max. 2 of scholarship that you received in the last 6 years. Please only include scholarships obtained based on merit.

Name of Scholarship Scholarship Level Scholarship Giver Type of Scholarship Year

5. WORKING EXPERIENCES
Please write your working experience start from current position.

Company Name : Industry :

Position : Month, Year :
Job Description : Reason for leaving :

Company Name : Industry :

Position : Month, Year :
Job Description : Reason for leaving :

Company Name : Industry :

Position : Month, Year :
Job Description : Reason for leaving :

Please draw your position in your current working structure organization, then upload the picture to the box below.

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6. REFERENCES AND PERSONAL QUESTONS

How do you get information about this vacancy?

Career Website :
Campus/Career Fair :
Recruitment Agency :
Referral :
Others :

Mention min. 2 names of your previous supervisor who can provide recommendations about you.

Full Name Position Company Name Telephone/Handphone Number

Please write 3 of your strengths

Please write 3 of your weakness

Answers
Questions
Y/N Explanation (if the answer "Y")

Company Name :
Have you worked at Adaro Group before? N Last Position :
Date of Join : to
What's the reason you left Adaro Group?

Have you been processed at Adaro Company Name :

N
Group recruitment before?
Applied Position :
Year :

Full Name :
Do you have any family member or any Company Name :
N
acquaintance who works at Adaro Group?
Position :
Relationship :
Mobile Phone No. :

Are you in a recruitment process at Company Name :

Y
other company? Applied Position :
Please write recruitment stages that you've followed.

** Cross your choice

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ADARO JOB APPLICATION

Answers
Questions
Y/N Explanation (if the answer "Y")

Company Name :
Are you on an official bond?
Year :

Are you willing to be assigned at another Yes, I will do my job anywhere for the sake of studying and having a career for my family
city?

I hereby declare that the information that I had provided is true and correct. I understand that Adaro Group have the right to reject my
application or cut off work relation if the information provided was found to be false.

............................, 28 Oct 2020

(..........................................................)

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