PT.

WIDODO MAKMUR UNGGAS

Application Form

Position Applied
Maintenance Supervisor

I. PERSONAL DATA

Full Name ALFIAN, S.T. M

Place/Date of Birth Palembang, 25 December 1994

ID Card Number 1671062512940012

Driving Licenses
A. No. 1117-9412-000030 B. No. C. No.

NPWP 82.342.632.5-301.000

Email Address Alfian.unsri@gmail.com

Religion Islam

Ethnicity Palembangnese

Marital Status Maried

Current Address : Kalen Tambo Pelabuhan Patimban Home Address : Perum Botania Garden Blok A6 no
Subang Jawa Barat 11 Batam

Home Number: Mobile Phone: Home Number: Mobile Phone:

085758121539 085758121539

Status: Status:
Contract Own

*) Choose the item by delete the others

II. FAMILY BACKGROUND

Relation Name Birthday Latest Education Current Job

Spouse Maysithah Zahrani 09 December 1996 D-III Not Work

Nurseha
 PT. WIDODO MAKMUR UNGGAS

Children
1 Hafsyah Hafidzhah 07 January 2020 - -

2. Family Tree, Including You

Relation Name Birthday Latest Education Current Job

Father
Suharli 15 june 1964 SMA Wiraswasta
Mother
Ros Mala Dewi 30 November 1967 SMA Not Work
Brothers/Sisters
Marisa 06 March 1989 D-III Not Work
1
Alfandi 27 January 2004 SMA Student
2

III. EDUCATIONAL BACKGROUND AND LANGUANGE COMPETENSCIES

1. Formal Education

Level School/University Major From Until GPA

Month/Year Month/Year

High School SMA N 18 Palembang Sains 2009 2012

Diploma

Bachelor Sriwijaya University Electrical 2012 2017 3.19

Engineering

Master
 PT. WIDODO MAKMUR UNGGAS

2. Non Formal Education (Include Course, Training, Seminar, etc)

Name of Course or Training Held by dd/mm/yy Notes

Welding Inspector IKBAL M YOS 2018

PLC training Jakarta Process 2018

Automation

3. Please give checklist (√) based on your language competencies

Foreign Language Competencies Spoken Written

English □ Active √ Passive √ Active □ Passive

Language ………… □ Active □ Passive □ Active □ Passive

Language ………… □ Active □ Passive □ Active □ Passive

IV. ORGANIZATIONAL BACKGROUND AND ACHIEVEMENTS

1. Social Activity

Name of Organization Field of Attendance Period Notes

Organization Periode

IKA UNSRI KEPRI SINGAPORE Campus Alumni 2017-2019

BEM KM UNSRI Campus 2015-2016

Organization
BEM KM FT UNSRI Campus 2014-2015
Organization
KALAM FT UNSRI Campus 2014-2015
Organization

2. Awards

Achievements Year Notes

Student College activist award 2016

 PT. WIDODO MAKMUR UNGGAS

V. WORKING EXPERIENCE

1. Please fill it descending, from your current/latest employment.

Company name Raya Konsult

Company Field Construction Consultant

Position Electrical Site

Inspector
From (mm/yy) – Until (mm/yy): October 2020 – July 2021

Job Description
- Supervision for Patimban Port Project
- Check all Design Electrical For Building & Electrical Network on
Project
- Inspect and Approve all contractor work related to electrical work
on field
- Make sure all of Material is used on Site is accordance with the
Material Approval Request
- Perfom the Site Inspection Test (Resistance test, magger test,
high voltage test, continuity test) and site Accaptance Test for all
Electrical work
- Supervise the electrical building construction and underground
power nertwork construction
- Supervise electrical test and commissioning work carried out by
contractors
- Make Progress report work to engineer

Please describe your current position in organizational chart!

ORGANIZATION CHART

Team
Leader

Engineer Inspector
 PT. WIDODO MAKMUR UNGGAS
Company name Flex Batam

Company Field PCB Assambly Manufacture

Position Equipment Sallary:

Maintenance 5.500.000,-
Engineer
From (mm/yy) – Until (mm/yy): October 2017 – October 2019

Reason to Leave Not good work environment

Company name Wilmar Group

Company Field Palm Oil Mill

Position Asisten Supervisor Sallary:

Maintenace 4.500.000,-

From (mm/yy) – Until (mm/yy): April 2017 – October 2017

Reason to Leave Looking for a job in area near the city

2. Please mention your former supervisors during your work history above.

No. Name Position Company Contact Number

1. Dedi Saputra Electrical Engineer Raya Konsult 083148801634

2. Jhon Karyadi Senior Manager FLEX BATAM 08127040028

3. Dodi Maintenance Wilmar Group 08126658741

Supervisor

3. Have you ever made innovation or change during your work history? Please explain.

- Gases Cut off automatic on PCB Oven Machine at FLEX Batam

 PT. WIDODO MAKMUR UNGGAS
VI. MEDICAL HISTORY

1. Please give checklist (√) and notes, based on your Medical history.

√ Diseases Has been hospitalized at (dd/mm/yy) Notes

Heart disease
□
□ Hypertension

□ Diabetes

□ Hepatitis

□ Cancer

□ TBC

□ Asthma

□ AIDS

□ Other Diseases

VII. REFERENCES

1. Please give names of colleagues for your references.

Name Phone Number

Muhammad Fadhli 0895411351122
Position Company
Mechanical Inspector Raya Suferindo
Relation
Work Partner

Name Phone Number

Heriyanto 081510037847
Company
Position MEP Engineer PT PP
Relation
Work Partner

2. Please give names we can contact in an emergency situation.

Name Name
Maysithah Zahrani Nurseha Suharli
Relation Relation
Wife Father
Phone Number 081394666166 Phone Number 081370791941
 PT. WIDODO MAKMUR UNGGAS

VIII. OTHERS

1. Please give checklist (√) and notes, based on your availability.

√ Your Availability on: Notes

To Relocated in other city Ready

√
√ To do business trip Ready

Do you have any relatives working in Widodo Makmur Group? Please State! No

Have you applied for any employment in Widodo Makmur Group before? If
No
yes, when and what position?

Have you ever officially engaged with Police Department in relation to

No
criminal issue, court of justice or civil cases?

Are you holding directorship or any other appointment in another company? No

If you are accepted, when you can start working? 12 july 2021

IX. REMUNERATION PACKAGE

1. Please fill this section with true fact as stated on your current salary slip or contract agreement.

Component of Salary Current Expectation

Salary NET. Rp.10.500.000,- NET. Rp.9.000.000,-

I declare that all information given herein is true and correct. I understand that any misrepresentation
or omission of facts will be sufficient cause for cancellation of consideration for employment or
dismissal from the Company’s service if I have been employed.

Subang, 07 Juny 2021

PT. WIDODO MAKMUR UNGGAS

(________ALFIAN, S.T.______ )