JOB APPLICATION FORM

Position Applied: ………………………………………………….

Notice:
a. To be filled in ‘CAPITAL LETTERS’ by the applicant and to attach a photo in size 4x6. All relevant certificates
and documents to be enclosed.
b. We PT. AMEYA LIVINGSTYLE INDONESIA have the right to cancel this application and subsequent contract,
if it were to be found that the information provided is not true and was meant to mislead the company.

I. PERSONAL DATA

Name : …………………………………………………………………………………..................................
Nickname : …………………………………………………………………………………..................................
No. ID : …………………………………………………………………………………..................................
Telephone / Handphone number : …………………………………………………………………………………..................................
Email Address : …………………………………………………………………………………..................................
Date / Place of Birth : …………………………………………………………………………………..................................
Temporary Address : …………………………………………………………………………………..................................
………………………………………………………………………………………………………………….
Permanent Address : …………………………………………………………………………………..................................
………………………………………………………………………………………………………………….
Religion : ……………………………………………… Nationality: …………………………………………...
Do you live in : Own house ( ) Rented house ( ) With parents ( ) Others ( )

II. FAMILY DETAIL STATUS

Marital Status: Single / Engaged since …………………… ; Married since …………………… ; Divorce since ……..…………….

RELATIONSHIP NAME AGE LOCATION OCCUPATION NAME OF EMPLOYER

Father
Mother

Brother / Sister

Spouse

Children

III. EDUCATION & PROFESSIONAL QUALIFICATION

STATE LEVEL ATTAINED MAJOR

FROM - TO NAME OF SCHOOL / COLLEGE
COURSE / SUBJECT

IV. ADDITIONAL QUALIFICATIONS

1.
2.
V. LANGUAGE & COMPUTER PROFICIENCY
1. LANGUAGES INDONESIA ENGLISH MANDARIN OTHER
 SPOKEN
WRITTEN
2. Computer proficiency Yes No Type …...…………………………………

VI. JOB / INTERNSHIP EXPERIENCES

Position @ Position @
Nature of Last
No Name of Company Period Time of Time of Department Reason of Leaving
Business Salary
Joining Leaving

1 Job Desc :

2 Job Desc :

3 Job Desc :

VII. GENERAL QUESTION (Please Answer Briefly)

1. Please kindly write down some short description about you as a self-introduction!
…………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………………
...………………………………………………………………………………………………………………………………………………………………
2. What do you consider you strength and weakness to be?
Strengths :…………………………………….………………………………………………………………………………
Weakness :……………………………………………………………………………………………………………………………
3. Motivation and Work Situation
Please rank the working condition bellow (1 st rank will be your most thing which can motivate your work,
continue till 12th for the last rank which can affect your work)
Ranking*
No Working Condition Present Condition
(Filled by the number of rank)
1 Good/kind superior Have Haven’t
2 Good/kind team or friend Have Haven’t
3 High Salary Have Haven’t
4 Work Assurance Have Haven’t
5 Support/Guarantee of Compensation Have Haven’t
6 Good/nice place Have Haven’t
7 Work Challenge Have Haven’t
8 Achievement/Acknowledge Have Haven’t
9 Growth Opportunity Have Haven’t
10 Given Responsibility Have Haven’t
11 Science/Skill Utilizing Have Haven’t
12 Progress Opportunity Have Haven’t
4. On Job confirmation, how soon can you start working in our company?
 ………………………………………………………………………………………………………………………………………………………………….
5. Salary/remuneration
Minimum Salary Expectation ………….………………………………………….

VIII. MEDICAL DETAILS

1. Do you have some serious illness, or allergic? Yes No

……………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………..….

IX. MISCELLANEOUS
1. Do you have any references? Who? …………………………………………………………………………………………………………….
…………………………………………………………………………………………………………….….……………………………………………………
2. Please inform the other number phone just in case as your guardian :
a. Name : ……………………………………………………………………..
b. No. Phone : ……………………………………………………………………..
c. Relation : ……………………………………………………………………..

Bantul, ……….………………………….
Candidate,

____
(Name & Signature)