APPLICATION FORM / PERSONAL INFORMATION – SHIP/HOTEL DEPARTMENT

PERSONAL DETAILS:

Applied Position Utility cleaner (Housekeeping Nationality Indonesia

Department)
First Name MAULANA Home Airport Surabaya
Last Name - Home Address incl. post Dsn. Probungan Kec. Klampis Kab.Bangkalan
code
Place & Date of Bangkalan, 24 August 1990 Telephone No. 083114191487/082245560869
Birth
Weight & Height 58kg & 165cm Email address Anamuzay8@gmail.com

RECORDS OF PREVIOUS EXPERIENCES (dimulai dari yg terahkir)

Ship, Hotel or Restaurant Name * Facility & Address of the hotel, Position Salary Employment Employment Reason for
(Nama Kapal/Hotel/Restoran) services rated (4 restaurant or start date end date leaving or
Start End
or 5 star)* agency current status
1. Hotel Bidakara Fancy Public area December 01, May 31, 2020 End of contract
Tunjungan Surabaya 2019
Job a) cleaning and maintaining restrooms and changing linens on bathroom racks.
Description b) cleaning windows and other surfaces using equipment such as
squeegees,mops,and buckets of soapy water, operating equipment such as
vacuums,floor buffers, and carpet shampooers.
c) Providing first aid and other medical assistance to guest as needed .

2 Hotel Bidakara Fancy Public area Rp. Rp.2.500.000 July 09, 2020 September 7, End of contract
Tunjungan Surabaya 2.500.000 2022
Job a) cleaning and maintaining restrooms and changing linens on bathroom racks
Description b) cleaning windows and other surfaces using equipment such as
squeegees,mops,and buckets of soapy water, operating equipment such as
vacuums,floor buffers, and carpet shampooers
c) Providing first aid and other medical assistance to guest as needed .

*Starts from the most recent workplace. Facility services rating for hotel and restaurant.

CERTIFICATES:

Course Institution Place Cert. Number Date of Issue

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 APPLICATION FORM / PERSONAL INFORMATION – SHIP/HOTEL DEPARTMENT
Basic Safety Training (BST) Surabaya 6212253984010522 07 Oct 2022
Crowd Management Surabaya 6212253984130522 15 Nov 2022
Crisis Management Surabaya 6212253984170522 15 Nov 2022

TRAVEL DOCUMENTS:

Type of document Number Place of issuance Date of issuance Date of expiry

PASSPORT C 9649108 Tanjung perak 22 Jun 2022 22 Jun 2027
SEAMAN BOOK H 072414 Surabaya 31 Oct 2022 31 Oct 2025

FORMAL EDUCATION BACKGROUND: (Latar belakang pendidikan formal)

School/Academy From (..Date/Month/Year..) To (..Date/Month/Year..) Qualification Attained

FC (First Course) 02/01/2023 16/06/2022 Hotel and criuse ship operation

REFERENCES:

Employer’s name Address and contact number Recommendation

Shohib mafburi Sepuluh-bangkalan

EMERGENCY CONTACT DETAILS:

No. Name Relationship Contact Number E-mail address

1 Muzayyana Sister Home 082245560869
Mobile
2 Marnihah Mother Home 083897351090
Mobile

NEXT OF KIN:(Saudara Sekandung)

No. Name Relationship Place / Date of Birth Phone No / Email

Asriyanti Sister

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 APPLICATION FORM / PERSONAL INFORMATION – SHIP/HOTEL DEPARTMENT

Declaration:

I hereby declared that the above mentioned information is correct.

Place & Date :

Signature : L i

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