JOB APPLICATION FORM

PERSONAL INFORMATION
Name : AGENG RIDHO PRABOWO
Place / Date of Birth : / 0000-00-00

No Photo
ID Card Number :

Address on ID Card :

Current Address :

Mobile Phone Number : Home Phone Number :

Email Address :
Office Phone Number :
edokanjelo0604@gmail.com
Gender : Blood Type :
Religion : NPWP Number :
BPJS Kesehatan
: BPJS Ketenagakerjaan Number :
Number
Status : Nationality :
:
Height Weight : Kg
cm
Sport / Hobbies :

In case of emergency : Phone Number :

who should we contact? Relationship :

FAMILY
Relationship Name Age Education Occupation Company/Institution

FORMAL EDUCATION
Degree Name & Location of Institution Major GPA Period Graduated
NON FORMAL EDUCATION/TRAINING/COURSE/SEMINAR (Start with the most recent.)
Type of
Date / Period Certified
education/training/course/seminar

ACADEMIC AND PROFESSIONAL ACTIVITIES AND ACHIEVEMENTS

Academic and professional activities, achievements, awards, publications,
Date/Period
or technical-professional communities. Indicate type or name

EMPLOYMENT HISTORY (Start with the most recent.)

Name & Address of

Company/Institution

Period (Month/Year) Entry: Exit:

Entry Position:
Position
Last Position:

Major Roles & Duties

Salary (Net) Entry: Last:

Other Benefits

Reason of Leaving

REFERENCES(list of referees who know your academic or professional performance,

not family member)
Name Address Phone Number Relation

SKILLS
Language (not your native language):
Reading Writing Speaking
Language
Poor Fair Good Poor Fair Good Poor Fair Good

Computer Skills

Other Skills
PREFERENCE OF PROFESSION
Accounting Finance Marketing
Sales Supply Chain MIS
Human Resources Production Engineering
R&D/QA Other :

PREFERENCE OF INDUSTRY
Manufacturing Financials Property
Natural Resources Retail & Trading Other :

SALARY EXPECTATION
IDR 0

ADDITIONAL INFORMATION
Have you ever applied to PT Gajah Tunggal Tbk before?

If yes, when?
Company: -
Do you have any special medical condition?

If yes, please explain: -

Other companies outside PT Gajah Tunggal Tbk you are applying to:
-

List of friends or relatives now employed by PT Gajah Tunggal Tbk:

Name Position Relationship

ESSAY
Please think about yourself and answer these questions:
1. What is your goals in life?
2. Please mention your strength and weaknesses!
3. What do people think or say about you?
4. Other information that you would like to share which may be helpful in considering your qualifications and interests.

1. -
2. -
3. -
4. -
PLEASE READ THIS STATEMENT CAREFULLY

I hereby confirm that the information given by me on this Job Application Form is accurate. I understand that any
falsification will be considered as a sufficient cause for dismissal. I authorize PT Gajah Tunggal Tbk to do a thorough
investigation in regards of this application concerning my personal information, education background, employment
history and any breach of rules.

________________________ _____/_____/________
Name & Signature Date

Thank you for taking time to complete this application

Form No: F-HR2-002 Rev. 2